Systematic Reviews of Research Evidence: Meta-Analysis, Metasynthesis, and Mixed Studies Review
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 29
Systematic Reviews of Research Evidence: Meta-Analysis,
Metasynthesis, and Mixed Studies Review
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Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Tell whether the following statement is true or false:
Evidence-based practice relies on rigorous integration of research evidence on a topic through systematic reviews.
Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
True
Evidence-based practice relies on rigorous integration of research evidence on a topic through systematic reviews. A systematic review methodically integrates research evidence about a specific research question using carefully developed sampling and data collection procedures that are spelled out in advanced in a protocol.
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Systematic Review
Integrates research evidence about research question
Carefully developed:
Sampling
Data collection procedures
Spelled out in advance in a protocol
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Question
Tell whether the following statement is true or false:
Systematic reviews of qualitative studies often involve statistical integration of findings through meta-analysis.
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Answer
False
Systematic reviews of quantitative studies often involve statistical integration of findings through meta-analysis, a procedure whose advantages include objectivity, enhanced power, and precision; meta-analysis is not appropriate, however, for broad questions or when there is substantial inconsistency of findings.
Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
Meta-Analysis
Objectivity
Enhanced power
Precision
Not appropriate
Broad questions
Substantial inconsistency of findings
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Criteria for Using Meta-Analytic Techniques in a Systematic Review
The research question being addressed or the hypothesis being tested across studies should be very similar, if not identical.
Concern regarding whether there is a sufficient base of knowledge for statistical integration
Consistency of evidence
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Steps in a Meta-Analysis
Formulating the problem
Designing the meta-analysis study
Searching the literature for data
Evaluating study quality
Extracting and encoding data for analysis
Calculating effects
Analyzing the data
Writing a meta-analytic report
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Question
Tell whether the following statement is true or false:
The steps in both quantitative and qualitative integration are similar.
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Answer
True
The steps in both quantitative and qualitative integration are similar and involve formulating the problem, designing the study, searching the literature for a sample of primary studies, evaluating study quality, extracting and encoding data for analysis, analyzing the data, and reporting the findings.
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Quantitative and Qualitative Research
Formulating the problem
Designing the study
Searching the literature for a sample of primary studies
Evaluating study quality
Extracting and encoding data for analysis
Analyzing the data
Reporting the findings
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Question
Tell whether the following statement is true or false:
There is consensus on systematic reviews should include the grey literature.
Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
False
There is no consensus on whether systematic reviews should include the grey literature—that is, unpublished reports.
Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
Concerns
No consensus on whether systematic reviews should include the grey literature
Quantitative studies
Bias against the null hypothesis
Publication bias
Examined with funnel plot
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Meta-Analysis
Effect size index: quantifies the magnitude and direction of relationship between variables
Two common effect size in nursing
Standardized mean difference
Odds ratio
Pooled to yield an estimate of the population effect size
Weighted average
Inverse variance
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Statistical Heterogeneity
Fixed effects model: assumes a single true effect size
Random effects model: assumes a distribution of effects
Forest plot
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Nonrandom Heterogeneity
Subgroup analyses
Meta regression
Purpose: identify clinical or methodologic features systematically related to variation in effects
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Quality Assessments
Exclude weak studies from reviews
Differentially weight studies or sensitivity analyses: test whether including or excluding weaker studies changes conclusions
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Question
Tell whether the following statement is true or false:
Metasyntheses are more than just summaries of prior quantitative findings; they involve a discovery of essential features of a body of findings and, typically, a transformation that yields new insights and interpretations.
Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
False
Metasyntheses are more than just summaries of prior qualitative findings; they involve a discovery of essential features of a body of findings and, typically, a transformation that yields new insights and interpretations.
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Undertaking Metasynthesis
“A family of methodologic approaches to developing new knowledge based on rigorous analysis of existing qualitative research findings”
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Approaches
Meta-ethnography
Metastudy
Metasummary
Critical interpretive synthesis (CIS)
Grounded formal theory
Thematic synthesis
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Metasynthesis Analysis
Analyzing and interpreting data
-Noblit and Hare approach
-Paterson and colleagues approach
-Sandelowski and Barroso approach
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Paterson and Colleagues
Metadata analysis: the study of results in a specific substantive area through analysis of the processed data
Metamethod: the study of the studies’ methodologic rigor
Metatheory: the analysis of the theoretical underpinnings on which the studies are grounded
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Sandelowski and Barroso
Summaries: descriptive synopses
Syntheses: interpretative explanations of the data
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Metasummary
Developing a list of abstracted findings from the primary studies
Manifest effect sizes
Frequency effect size
Intensity effect size
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Mixed Methods Research
Systematic mixed studies reviews
Systematic reviews
Disciplined
Auditable
Integrate and synthesize findings
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Reporting Guidelines
PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) is useful for writing up a systematic review of RCTs.
MOOSE (Meta-analysis of Observational Studies in Epidemiology) guides reporting of meta-analyses of observational studies.
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