Module Components

• Learning Activities

Topics

• Steps in the Development of a Search Strategy
• Types of Evidence in theLliterature
• Summarizing Your Search
• Commonly Used Reviews
• Search Strategies
• Resources for EBP
• Additional Training Available at Health Sciences & Human Services Library
• Module 7 Self-Review

NRSG 790 - Methods for Research and Evidence-Based Practice

Module 7: Searching for and Retrieving Evidence

COMMONLY USED REVIEWS

The literature search is probably the single most important component in the search for quality evidence. Incomplete or biased searches usually result in an inadequate collection of evidence that carries the potential for faulty conclusions (Whittemore, 2005).

The major types of reviews are:

• Narrative
• Integrative
• Meta-analysis
• Systematic

Narrative reviews

Narrative reviews are frequently found in trade publications and deal with a broad range of issues related to a given topic. For example, a narrative review on hypertension might begin with the pathophysiology of hypertension, epidemiological data, diagnostic and screening modalities followed by treatment, patient/family education and preventive measures. Narrative reviews are helpful when examining the history of a clinical issue or problem or when the theory or context of data is being examined.

Integrative reviews

Integrative reviews are the broadest category of research reviews. They provide a summary of the literature on a specific concept or content area. The research is summarized, analyzed and overall conclusions are drawn (Redeker, 2000). Ganong (1987) is credited with clarifying the steps of conducting integrative reviews in nursing. She utilized a grid format that included methods, theories and empirical results. Integrative reviews are frequently conducted by panels of experts which results in less bias or error in the conclusions.

Meta-analysis reviews

Meta-analysis reviews combine the evidence of multiple primary studies into measurable formats and statistically estimate the effect of proposed interventions. Studies are similar or may even be identical so statistical comparisons can be made. The sample is usually narrow because the studies have to be similar. These reviews can include both published and unpublished data (Schmidt & Brown, 2009). Overall effects and magnitude of the effects are identified.

Click here to watch this video clip for an overview of meta-analysis by Dr. George Zangaro. It runs 15:25.

Note: To view the video clip, sign into Mediasite using your UMB account username and password (this is the same username and password that is used to access Blackboard). For more information on how to access Mediasite, go to the Mediasite Help folder under Online Modules.

Systematic reviews

Systematic reviews combine elements from the previous three methods. This type of review is particularly helpful when there are large quantities of research that need to be summarized and communicated. A systematic review is similar to conducting a research study with the major difference being instead of human subjects, research articles or reports are the primary focus of study. Systematic reviews usually answer specific, even narrow, clinical questions. A well-developed systematic review can clearly delineate what is known and unknown about the clinical problem. Inconsistencies in the research are more easily identified. Clinical questions can be restated or refined based on these summaries. Systematic reviews help clarify future research studies and provide clarity regarding outcomes and policy issues. Systematic reviews are comprehensive reviews of all applicable evidence. They are typically completed by at least two or more people.

Systematic reviews can be found at the following sites

• The Cochrane Library consists of a regularly updated collection of evidence-based medicine databases, including The Cochrane Database of Systematic Reviews. This database includes systematic reviews of healthcare interventions that are produced and disseminated by The Cochrane Collaboration.
• PROSPERO is an international database of prospectively registered systematic reviews in health and social care, welfare, public health, education, crime, justice, and international development, where there is a health related outcome. PROSPERO is produced by CRD and funded by the National Institute for Health Research (NIHR).

• The Joanna Briggs Institute (JBI) is an International not-for-profit Research and Development Organization specializing in Evidence-Based resources for healthcare professionals in nursing, midwifery, medicine, and allied health. The JBI Model of Evidence Based Health Care conceptualizes evidence based practice as clinical decision making that gives equal weight to the best available evidence; the context in which the care is delivered; client preference; and the professional judgment of the health professional.

Click here to watch this video clip for an overview of systematic reviews by Dr. Meg Johantgen. It runs 12:53

References:

• Schmidt, N.A. & Brown, J.M. (2009). Evidence-based practice for nurses. Boston: Jones & Bartlett.
• Whittemore, R. (2005). Combining evidence in nursing research. Nursing Research, 54(1), 56-62.