transcranial alternating current stimulation

Stages

1. 1.
   Literature search across bibliographic databases(in_silico_filter)

   To identify the body of eligible literature across multiple databases before screening and synthesis.

   Selection: Studies investigating efficacy and safety of non-invasive nerve and brain stimulation techniques for management of drug-resistant epilepsy.

2. 2.
   Independent study screening(broad_screen)

   To filter search results to relevant studies using independent reviewers.

   Selection: Relevant studies identified from database searches.

3. 3.
   Data extraction and risk-of-bias assessment(functional_characterization)

   To collect outcome data and assess study quality before quantitative synthesis.

   Selection: Screened-in relevant studies.

4. 4.
   Meta-analysis of primary outcome(confirmatory_validation)

   To quantitatively assess the primary efficacy outcome across included studies.

   Selection: Extracted primary outcome data on seizure reduction.

5. 5.
   Subgroup analysis for heterogeneity and protocol settings(secondary_characterization)

   To investigate why results differ across studies and to identify optimal stimulation parameters for each intervention where possible.

   Selection: Included studies and pooled outcome data.

6. 6.
   Sensitivity analysis for robustness(decision_gate)

   To test whether the synthesized results remain stable under alternative analytical assumptions or study subsets.

   Selection: Meta-analytic and subgroup-analysis results.

Steps

1. 1.
   Search bibliographic databases for relevant DRE neuromodulation studies

   Identify studies on efficacy and safety of non-invasive nerve and brain stimulation techniques for drug-resistant epilepsy.

   Relevant literature must be assembled before screening, extraction, and synthesis can occur.

2. 2.
   Independently screen retrieved studies in Covidence

   Determine which retrieved studies are relevant for inclusion.

   Screening follows retrieval so irrelevant records can be removed before detailed extraction.

3. 3.
   Resolve screening discrepancies with a third reviewer

   Adjudicate disagreements in study selection.

   Discrepancy resolution is needed after independent screening and before final inclusion decisions.

4. 4.
   Extract study data and assess risk of bias

   Collect outcome and study-quality information needed for synthesis.

   Quantitative synthesis depends on having extracted outcomes and quality assessments from included studies.

5. 5.
   Perform meta-analysis on seizure reduction outcomes

   Quantitatively assess the primary efficacy outcome across included studies.

   Meta-analysis follows data extraction because pooled estimates require harmonized outcome data.

6. 6.
   Run subgroup analyses to examine heterogeneity and optimal settings

   Identify potential sources of heterogeneity and optimal protocol settings for each intervention.

   Subgroup analysis is performed after pooled analysis so differences across studies and parameter regimes can be interpreted in context of overall results.

7. 7.
   Conduct sensitivity analyses to test robustness

   Evaluate how robust the synthesized results are.

   Robustness testing follows the main and subgroup analyses so conclusions can be checked before final interpretation.

Stages

1. 1.
   Study shortlisting from research databases(selection)

   To narrow the literature to studies meeting the authors' defined review criteria before analysis.

   Selection: defined criteria applied to studies from well-known research databases

2. 2.
   Categorization by brain stimulation technique(hit_picking)

   To organize shortlisted studies into comparable stimulation modality groups for downstream analysis.

   Selection: assignment of shortlisted studies into brain stimulation technique categories

3. 3.
   Analysis of shortlisted studies(secondary_characterization)

   To synthesize what the shortlisted literature shows about benefits of closed-loop BCI and where coverage remains inadequate.

   Selection: analysis of the shortlisted study set to assess benefits and literature gaps

Steps

1. 1.
   Apply defined criteria to studies from well-known research databases

   To identify which studies should be shortlisted for the review.

   The literature must be narrowed before studies can be categorized and analyzed.

2. 2.
   Group shortlisted studies into stimulation technique categories

   To organize the shortlisted literature by modality for structured comparison.

   Categorization follows shortlisting so that only included studies are organized for analysis.

3. 3.
   Analyze the 76 shortlisted studies for benefits and coverage gaps

   To synthesize evidence for functional improvement and identify undercovered application areas.

   Analysis is performed after shortlisting and categorization so the final corpus is defined and organized.