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Review Methods (review + methods)

Distribution by Scientific Domains

Medical Sciences	83%
Humanities and Social Sciences	16%

Selected Abstracts

Centralization and the relationship between volume and outcome in knee arthroplasty procedures

ANZ JOURNAL OF SURGERY, Issue 4 2010
Nicholas E. Marlow
Abstract Background:, Centralization aims to reduce adverse patient outcomes by concentrating complex surgical procedures in specified hospitals. Objectives:, This review assessed the efficacy of centralization for knee arthroplasty by examining the relationship between hospital and surgeon volume and patient outcomes. Data Sources and Review Methods:, The systematic review identified studies using multiple databases, including Medline and Embase. Two independent researchers ensured studies met the inclusion criteria. Morbidity, mortality, length of stay, financial outcomes and statistical rigour were examined. Correlations between volume and outcome were reported. Results:, Twelve primary knee arthroplasty studies examined hospital volume, which was significantly associated with decreased morbidity (five of seven studies), mortality (two of five studies) and length of stay (two of three studies). Three primary knee arthroplasty studies examined surgeon volume, which was significantly associated with decreased morbidity (two of three studies), mortality (zero of two studies) and length of stay (one of one study). Two revision knee arthroplasty studies examined hospital volume. One study examined but did not test for significance between hospital volume and patient morbidity; both studies examined volume and patient mortality reporting inconclusive results; and one study reported no significant association between volume and length of stay. None of the revision knee arthroplasty studies examined surgeon volume. Conclusions:, Significant associations between increased hospital and surgeon volume and improved patient outcomes were reported. However, when these results were separated by arthroplasty type, the association appeared tenuous. Judgements regarding centralization of knee arthroplasty should be made with caution until further evidence is published. [source]

The challenge of external validity in policy-relevant systematic reviews: a case study from the field of substance misuse

ADDICTION, Issue 1 2010
Mark Pearson
ABSTRACT Aim To critically evaluate the methods utilized in the conduct of a systematic review in the field of substance misuse Design Participant-observation in the review process, semi-structured interviews with review team members and management and structured observation of the process of guidance development. Setting An ,arm's-length' government body. Participants Review team members, management and the committee responsible for producing evidence-based guidance for policy and practice. Measurements Data from interviews and (participant-)observation were reflected upon critically in order to increase understanding of the systematic review process. Findings The application of systematic review methods produced an evidence base that did not inform the development of guidance to the extent that it could have done: (i) an emphasis upon internal research validity produced an evidence base with an emphasis on short-term interventions at the level of the individual; (ii) criteria for appraising the external validity of studies were not developed sufficiently; and (iii) the systematic review of evidence and development of guidance are strongly reliant upon the judgement of reviewers and committee members. Conclusions Prioritizing internal validity in a systematic review risks producing an evidence base that is not informed adequately by the wider determinants of health and which does not give sufficient consideration to external validity. The use of appropriate methods requires that commissioners of systematic reviews are clear at the outset how the review is proposed to be utilized. Review methods such as meta-ethnography and realist synthesis could contribute to making the frameworks within which judgements are made more explicit. [source]

How can we increase the involvement of primary health care in the treatment of tobacco dependence?

ADDICTION, Issue 3 2004
A meta-analysis
ABSTRACT Aims A systematic review of studies testing the effectiveness of educational and practice base strategies to increase the involvement of primary health-care practitioners in the treatment of tobacco dependence. Data sources MEDLINE, EMBASE, CINAHL and the Cochrane Library (1966,2001). Selection criteria included studies that used randomized or controlled clinical designs, controlled before and after trials and interrupted time-series designs and that presented objective and interpretable measures of practitioners' behaviour and biochemically verified patient quit rates. Review methods A meta-analysis, using a random effects model, of 24 programmes identified in 19 trials. Effect sizes were adjusted by inverse variance weights to control for studies' sample sizes. Findings Analyses to explain the heterogeneity of effect sizes found that interventions were equally effective in changing practitioners' screening and advice-giving rates and their patients' quit rates. Absolute increases for the intervention above the comparison groups were 15% (95% CI = 7,22) for screening rates, 13% (95% CI = 9,18) for advice-giving rates and 4.7% (95% CI = 2.5,6.9) for biochemically verified patient quit rates. Practitioners in training programmes were effective in changing their patients' quit rates but not their own screening rates; educational interventions were more effective than practice-based interventions. For established practitioners, programmes were effective in changing their screening and advice-giving rates, but not their patients' quit rates; a combination of practice-based and educational interventions were more effective. Conclusions Primary health-care practitioners can be engaged in the treatment of tobacco dependence to increase equally their screening and advice-giving rates and their patients' quit rates with outcomes of considerable public health and clinical significance. The provision of educational interventions for practitioners in training in combination with systematic outreach practice-based support for established practitioners is likely to be an effective strategy to increase smoking quit rates throughout primary health care. [source]

Antibacterial efficacy of calcium hydroxide intracanal dressing: a systematic review and meta-analysis

INTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2007
C. Sathorn
Abstract Aim, To determine to what extent does calcium hydroxide intracanal medication eliminate bacteria from human root canals, compared with the same canals before medication, as measured by the number of positive cultures, in patients undergoing root canal treatment for apical periodontitis (teeth with an infected root canal system). Methodology, CENTRAL, MEDLINE and EMBASE databases were searched. Reference lists from identified articles were scanned. A forward search was undertaken on the authors of the identified articles. Papers that had cited these articles were also identified through the Science Citation Index to identify potentially relevant subsequent primary research. Review methods, The included studies were pre-/post-test clinical trials comparing the number of positive bacterial cultures from treated canals. Data in those studies were independently extracted. Risk differences of included studies were combined using the generic inverse variance and random effect method. Results, Eight studies were identified and included in the review, covering 257 cases. Sample size varied from 18 to 60 cases; six studies demonstrated a statistically significant difference between pre- and post-medicated canals, whilst two did not. There was considerable heterogeneity among studies. Pooled risk difference was ,21%; 95% CI: ,47% to 6%. The difference between pre- and post-medication was not statistically significant (P = 0.12). Conclusions, Calcium hydroxide has limited effectiveness in eliminating bacteria from human root canal when assessed by culture techniques. [source]

A meta-analysis of the vascular-related safety profile and efficacy of ,-adrenergic blockers for symptoms related to benign prostatic hyperplasia

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2008
J. C. Nickel
Summary Objectives:, To evaluate the safety profile and efficacy of ,1-adrenergic receptor blockers (A1Bs) currently prescribed for benign prostatic hyperplasia (BPH). Data sources:, A systematic literature search of MEDLINE, the Cochrane Database and the Food and Drug Administration Web site through December 2006 identified double-blinded, prospective, placebo-controlled trials, evaluating agents commercially available by prescription for the symptomatic treatment of BPH. Review methods:, Data were reviewed by two investigators with the use of a standardised data abstraction form. Studies were evaluated for methodological quality using the Jadad scale. Studies with a score of < 3 were considered of weaker methodology. Results:, Of 2389 potential citations, 25 were usable for evaluation of safety data, 26 for efficacy. A1B use was associated with a statistically significant increase in the odds of developing a vascular-related event [odds ratio (OR) 2.54; 95% confidence interval (CI): 2.00,3.24; p < 0.0001]. The odds of developing a vascular-related adverse event were: alfuzosin, OR 1.66, 95% CI: 1.17,2.36; terazosin, OR 3.71, 95% CI: 2.48,5.53; doxazosin, OR 3.32, 95% CI: 2.10,5.23 and tamsulosin, OR 1.42, 95% CI: 0.99,2.05. A1Bs increased Qmax by 1.32 ml/min (95% CI: 1.07,1.57) compared with placebo. Difference from placebo in American Urological Association symptom index/International Prostate Symptom Score was ,1.92 points (95% CI: ,2.71 to ,1.14). Conclusions:, Alfuzosin, terazosin and doxazosin showed a statistically significant increased risk of developing vascular-related events compared with placebo. Tamsulosin showed a numerical increase that was not statistically significant. All agents significantly improved Qmax and symptom signs compared with placebo. [source]

A systematic review on communicating with patients about evidence

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2006
Lyndal J Trevena MBBS (Hons) MPhilPH
Abstract Objective, To conduct a systematic search for (1) the effectiveness of evidence-based communication tools to increase patient understanding of evidence, (2) effective formats for representing probabilistic information and (3) effective strategies for eliciting patient preferences about evidence. A case scenario is used to illustrate some of the difficulties of putting these results into practice., ,Data sources, Systematic search of The Cochrane Library, Medline, Psychinfo, Embase and Cancerlit. Review methods, Systematic reviews of randomized controlled trials (RCTs) and high quality RCTs were included. Studies were excluded if they did not address the question, were focused on behavioural outcomes without attempting to increase understanding, were concerned with counselling as a therapeutic intervention, or were specific to communication regarding clinical trial participation., ,Results, We found 10 systematic reviews of RCTs and 30 additional RCTs addressing our questions. Communication tools in most formats (verbal, written, video, provider-delivered, computer-based) will increase patients' understanding but are more likely to do so if structured, tailored and/or interactive. Probabilistic information is best represented as event rates (natural frequencies) in relevant groups of people, rather than words, probabilities or summarized as effect measures such as relative risk reduction. Illustrations such as cartoons, or graphs (vertical bar charts) appear to aid understanding. Values clarification exercises may be better than standard utility techniques for eliciting preferences in individual decision making. Looking for effective evidence-based communication tools for prostatic specific antigen testing highlighted the challenges for clinicians and consumers in accessing tools that are evidence-based in design as well as content. Conclusion, There is an increasing body of evidence supporting the design of effective evidence-based communication tools but variable access to such tools in practice. [source]

Hygiene interventions for prevention of cytomegalovirus infection among childbearing women: systematic review

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2009
Richard Reading
Hygiene interventions for prevention of cytomegalovirus infection among childbearing women: systematic review . HarveyJ. & DennisC.-L. ( 2008 ) Journal of Advanced Nursing , 63 , 440 , 450 . Aim This paper is a report of a systematic review to examine the effectiveness of preventive interventions to reduce congenital cytomegalovirus transmission and infection among women of childbearing age. Background Congenital cytomegalovirus has been identified as the leading infectious cause of damage to the growing fetus in developed countries, including Down's syndrome, fetal alcohol syndrome and spina bifida. Despite the prevalence and consequences of this infection, it has a low profile and pregnant mothers are often unaware of the risks and protective behaviours related to its transmission. Women with children in day care and nurses working with children are particularly at risk of acquiring the virus. Data sources A computerized literature search for papers up to 1 December 2007 was performed using MEDLINE (from 1950), EMBASE (from 1980) and CINAHL (from 1982). Review methods Both authors independently reviewed studies that met inclusion criteria and assigned a quality rating determined by the number of validity criteria met. Differences were discussed until consensus was reached. Findings Differences in hygiene behaviour changes were most statistically significant for pregnant, seronegative women. Although the methodological quality of the three included studies was not strong, seroconversion rates consistently decreased as cytomegalovirus education and support increased. Conclusion Nurses can act as preventive agents for cytomegalovirus infection through education about hygiene precautions during antenatal care and through preventive measures in the workplace. The review findings suggest that educational interventions in hygiene practices have the potential to be a feasible, large-scale, primary prevention strategy. [source]

The challenge of external validity in policy-relevant systematic reviews: a case study from the field of substance misuse

Generalizability and transferability of meta-synthesis research findings

JOURNAL OF ADVANCED NURSING, Issue 2 2010
Deborah Finfgeld-Connett
finfgeld-connett d. (2010) Generalizability and transferability of meta-synthesis research findings. Journal of Advanced Nursing 66(2), 246,254. Abstract Title.,Generalizability and transferability of meta-synthesis research findings. Aim., This paper is a report of a critical analysis of the generalizability and transferability of meta-synthesis research findings. Background., Findings from a large number of qualitative research investigations have had little impact on clinical practice and policy formation. Single qualitative investigations are not intended to produce findings that are directly applicable to clinical practice, simple literature reviews of qualitative studies are not conducted using sophisticated methods to develop new cumulative knowledge, and methods for systematically compiling and synthesizing qualitative findings have just recently been developed in nursing. Data sources., This analysis of qualitative review methods was based on over 10 years of meta-synthesis research experience and a non-time-limited cross-discipline search of the English-language literature related to qualitative research and generalizability. Discussion., Generalizability of meta-synthesis findings is enhanced by insuring validity through systematic sampling, second-tier triangulation, maintenance of well-documented audit trails and the development of multi-dimensional theory. Generalizability of meta-synthesis findings is tentative until successful transference to new situations takes place. Implications for nursing., Nurse researchers are urged to conduct well-designed and executed meta-synthesis investigations that have the potential to generate findings that are relevant to clinical practice and policy formation. They are also encouraged to disseminate their meta-synthesis findings skilfully and work with practitioners and policy-makers to apply and evaluate them judiciously in clinical settings. Conclusion., Qualitative meta-synthesis is a way of putting together qualitative findings from disparate investigations so that they can more readily be used in clinical practice and policy formation. [source]

The integrative review: updated methodology

JOURNAL OF ADVANCED NURSING, Issue 5 2005
Robin Whittemore PhD APRN
Aim., The aim of this paper is to distinguish the integrative review method from other review methods and to propose methodological strategies specific to the integrative review method to enhance the rigour of the process. Background., Recent evidence-based practice initiatives have increased the need for and the production of all types of reviews of the literature (integrative reviews, systematic reviews, meta-analyses, and qualitative reviews). The integrative review method is the only approach that allows for the combination of diverse methodologies (for example, experimental and non-experimental research), and has the potential to play a greater role in evidence-based practice for nursing. With respect to the integrative review method, strategies to enhance data collection and extraction have been developed; however, methods of analysis, synthesis, and conclusion drawing remain poorly formulated. Discussion., A modified framework for research reviews is presented to address issues specific to the integrative review method. Issues related to specifying the review purpose, searching the literature, evaluating data from primary sources, analysing data, and presenting the results are discussed. Data analysis methods of qualitative research are proposed as strategies that enhance the rigour of combining diverse methodologies as well as empirical and theoretical sources in an integrative review. Conclusion., An updated integrative review method has the potential to allow for diverse primary research methods to become a greater part of evidence-based practice initiatives. [source]

Systematic reviews: gatekeepers of nursing knowledge

JOURNAL OF CLINICAL NURSING, Issue 5 2001
David Evans BN, DipN
,,The past few decades have seen a considerable increase in the number of available health care products and interventions. This growth has been matched by a similar expansion in the health care literature. As a result of these factors, the demand for evidence to support practice is growing, but finding the best evidence is becoming increasingly difficult. ,,In response, the use of systematic reviews is increasing and they are starting to replace the primary research as the basis for health care decisions. ,,To date, these reviews have focused predominantly on effectiveness and so have been limited to randomized controlled trials. As a result of this, the interpretive, observational and descriptive research methods that are utilized by nursing have commonly been either excluded from the review or are classified as ,low level' evidence. ,,To address this, nursing must participate in the development of systematic review methods that better answer the questions posed by the profession. [source]

A review of generalization methods used in empirical social work literature

INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 4 2009
Marina Lalayants
This article reviews methods currently used for generalization of findings, based on a review of a representative sample of empirical research studies drawn from three major social work research journals: Social Work Research, Journal of Social Service Research, and Research on Social Work Practice, over a 10-year period (1996,2005). Findings revealed a greater discussion of generalizability limitations in comparison with the past, and other types of generalization methods such as conceptual generalizations and qualitative comparisons of study results with those of other studies. Relatively low usage of quantitative comparisons of sample to population and replication procedures was detected. Implications of these trends are discussed and approaches for improvements are explored. [source]