Removing Duplicates

There are two forms of deduplication to consider when conducting a systematic review. The first is the removal of identical records retrieved from multiple databases. The second is the issue of multiple articles published from the same data set. If undetected, either could create bias in the conclusions of your review. 

Identifying and removing duplicate records is necessary because multiple databases often index overlapping journals. Your method of deduplication may depend on the number of articles included in your review: manual deduplication is more realistic with smaller numbers, whereas larger numbers may require automatic tools. Automatic tools are not perfect, so both methods should be used for accurate deduplication. Whichever process you decide to follow, document it and report it accurately in your article. 

Identifying multiple articles published from the same data set is a bit more complicated. The Cochrane Handbook offers some good suggestions for authors here: https://training.cochrane.org/handbook/current/chapter-04#section-4-6-2, and recommends that studies (not reports) serve as the reporting unit (https://training.cochrane.org/handbook/current/chapter-04#_Ref531774783). This requires careful analysis because you don't want to leave out important articles. 

You need to track the number of duplicate articles you remove for either reason for inclusion in your PRISMA diagram. 

You may want to export the entire list of articles from each database to a citation manager such as EndNote, Sciwheel, Zotero, or Mendeley (including both citation and abstract in your file) and remove the duplicates there. If you are using Covidence for your review, you should also add the duplicate articles identified in Covidence to the citation manager number.

When you search in each Ebscohost database by itself the results will be deduplicated automatically, however when you search in more then one the databases, the number of results posted on the first page (unless it says duplicates have been removed), includes duplicate articles. 

1. In this example, I will search in Cinahl and Medline together. 
2. Enter your search terms, then click on search. Then apply your limiters. Here is my example search.
3. Be sure you have results per page set to 50 (which is the maximum amount). To do this click on "page options", then under "results per page" change it to 50. Then select "Apply".
4. You can see in this set of results that there are 74 results listed on the first page, to see how many of them are duplicates you will need to click on the last page of the results. To do this, scroll down, then click on the last page (in this case page 2). 
5. You will notice as soon as the last page loads, at the top of the results it says "Note: Exact Duplicates Removed from Results." And the number of results has dropped to 70. Therefore, 4 of the results in this list are duplicates. 

To remove duplicates from any ProQuest database, scroll down on the advanced search page and click on the Result page options link and then check the box next to Exclude duplicate documents.

Export your references to a CSV or Excel file. In most cases, you will need to first use conditional formatting in Excel to identify duplicates, then do a final scan manually.

Conditional formatting 

• Sort the column alphabetically. (Start with titles, though you can use this same process for any other columns you choose, such as DOI.) 

• Select conditional formatting from the Home ribbon, go to Highlight Cells Rules, then Duplicate Values.

• Replace punctuation (dashes, periods, question marks, semi colons, colons) in titles with spaces using the find and replace tool. 

• For titles, truncating (to 30 characters, for example, though this number is arbitrary) will sometimes find more duplicates.

  • insert a blank column

  • use this formula =LEFT(C2,30) where C2 is the cell you are truncating

  • copy the formula down the length of the column to truncate it all

Manual scan

• Sort by title 

• Scan through the list, looking for duplicate titles

• Check the additional information (author, journal, volume, page number) to make sure it matches before designating a duplicate

DO NOT delete duplicate records. Instead, move them to a separate sheet for duplicates, to track numbers.

This process was adapted from Kwon (2015). 

Most bibliographic management software includes a deduplication option. You might consider uploading your references to EndNote, for example, removing the duplicates, and then going through the remainder of your list manually. Qi (2013) found that one method of automatic deduplicating was inadequate. See the following YouTube on integrating PRISMA with EndNote. 

Before deduplicating, you will need a merged EndNote library containing the records from all your separate EndNote libraries for the individual database searches, if you had previously exported records from each database into separate libraries:

• Create a new EndNote library that will contain the records from all the databases you searched (I like to put DEDUPING in the EndNote library name)
• Import the records from each EndNote library you created for the individual database searches:
  • Go to EndNote menu > File > Import >
  • File Next to "Import File", browse to choose the .enl file (NOT the .enlx file) for each library of downloaded records from your searches and select "EndNote Library" as the "Import Option"
  • Once all the records have been added to this new library, check to make sure the final number of records, before removing duplicates, matches the sum of the records found for all the database searches
• Using this merged library of records from your individual database searches, you are now ready to remove duplicates. Here are three methods you can use:

1. After you have merged your libraries, with the Library window open, click on the All References group to show all references.
2. From the Library menu, choose Find Duplicates.
   EndNote will display a Find Duplicates dialog, where you can compare duplicates and decide which version to keep and which to delete. Be sure you keep track of the number of duplicates you are deleting.
3. For each set of duplicates, you have the option to:
   • Click Keep This Record to save that particular reference and throw the other one in the Trash.
   • Click Skip to leave both references in the library, intact. They will appear in a temporary Duplicate References group, so you can review them later.
   • Click Cancel to automatically instruct EndNote to select the most recently-entered version(s) of each duplicate reference as the one(s) to be removed. If you move the selected references to the trash, they will be removed from the library, removing all duplicate copies EndNote found. All duplicates  (including the original copy of the reference which will not be selected when the group window is created) will appear in a temporary Duplicate References group if you wish to review them. Do NOT simply move all references in the Duplicate References group to the trash unless you want to remove all copies of all references duplicated, including the original.

Earlier version of "Bramer method" for deduplicating, with steps provided in Word document format: 

• Paper describing more advanced configuration options for removing duplicates in EndNote: Bramer WM, Giustini D, de Jonge GB, Holland L, Bekhuis T. De-duplication of database search results for systematic reviews in EndNote. Journal of the Medical Library Association : JMLA. 2016;104(3):240-243. doi:10.3163/1536-5050.104.3.014

After deduplication - Create a compressed library for backup after having removed as many duplicates as possible, with a filename like SearchTerms-yyyymmdd-Deduplicated—xRecords.enlx. This will be the library for screening.

These tutorials will get you started on the deduplication process:

• Zotero (free open access)

• RefWorks

• Mendeley

• Covidence also includes automatic deduplication. One limitation to using Covidence for deduplication is that you cannot easily review duplicates manually after the automatic deduplication is complete, because Covidence limits the number of records displayed on a page. APU does not have a subscription to this resource however you can set up an individual trial by contacting the company.

Removing duplicate references obtained from different databases is an essential step when conducting and updating systematic literature reviews. ASySD is a tool to automatically identify and remove duplicate records. Hair, et al. (2021) compared ASySD deduplication to SRA-DM & Endnote. They found that "ASySD identified more duplicates than either SRA-DM or Endnote, with a sensitivity in different datasets of 0.95 to 0.99. The false-positive rate was comparable to human performance, with a specificity of 0.94-0.99. The tool took less than 1 hour to deduplicate all datasets" (Hair, et al, 2021).

The tool is written in R and has been created as a Shiny web app available online. For very large datasets (>50,000 records) it is advisable to download the code and run locally as a Shiny app within RStudio.

1. Go to https://camarades.shinyapps.io/RDedup/
2. Upload reference library as an .XML file direct from Endnote, a .csv file or a .txt tab delimited file.
3. Specify any labelled records to preferentially keep in the library e.g. keep references obtained in a previous search labelled as "old" over the same records found in a new search
4. Navigate to the Deduplicate data tab and click a single button in the Automated Deduplication section to remove duplicates automatically. Depending on the size of the dataset, this can take several minutes. ASySD will highlight how many records have been removed.
5. Remove any additional duplicates manually under the Manual Deduplication section. Select the IDs you want to remove from the side-by-side table of matching duplicates and click to remove from your reference library
6. Download unique reference library (there are several options here - for example to download your library after automated de-duplication only or to download the reference pairs ASySD detected)

Removing duplicate records with the IEBH SR-Accelerator Deduplicator

• Use the online Deduplicator tool. This is a new version as of August 2021.
• Help using Deduplicator

Large sets of records

• The offline DeDuplicator (old version) may be useful for large sets of records (which used to be considered ≥ 2000). Download the SRA-dedupe-UI application from GitHub. As of October 2020, there were only Linux and Windows versions available.
• Help using DeDuplicator Offline
• When exporting your records to an XML file, don't forget to select them all (Help Importing/Exporting EndNote records)
• If you choose to use the stand alone executable version for Windows, you may get a message that "Windows protected your PC": Click on More info and then a Run anyway button will appear, which you should click if you feel comfortable trusting the software developers
• Keep a copy of the RIS or XML file for your records.

Bramer, W. M., Giustini, D., de Jonge, G. B., Holland, L., & Bekhuis, T. (2016). De-duplication of database search results for systematic reviews in EndNote. Journal of the Medical Library Association : JMLA, 104(3), 240–243. https://doi.org/10.3163/1536-5050.104.3.014

Kwon, Y., Lemieux, M., McTavish, J., & Wathen, N. (2015). Identifying and removing duplicate records from systematic review searches. Journal of the Medical Library Association : JMLA, 103(4), 184–188. https://doi.org/10.3163/1536-5050.103.4.004 

Qi, X., Yang, M., Ren, W., & Jia, J. (2013). Find duplicates among the PubMed, EMBASE, and Cochrane Library databases in systematic review. PLoS ONE 8(8): e71838. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0071838

Rathbone, J., Carter, M., Hoffmann, T., & Glasziou, P. (2015). Better duplicate detection for systematic reviewers: evaluation of Systematic Review Assistant-Deduplication Module. Systematic Reviews, 4(6), 1-6. https://doi.org/10.1186/2046-4053-4-6

Hair, K., Bahor, Z., Macleod, M.R., Liao, J., & Sena, E.S. (2021). The Automated Systematic Search Deduplicator (ASySD): a rapid, open-source, interoperable tool to remove duplicate citations in biomedical systematic reviews. bioRxiv. https://doi.org/10.1101/2021.05.04.442412