Research week 4Chapter 18

Theoretical Framework

It is a systematic explanation about how phenomena are interrelated Used when the variables have been studied before and have been found to be related to one another

Theoretical framework provides what for the development of a hypothesis?

provides a rational

Steps in Conducting a Systematic Review

1. problem formation- developing research Q 2. Design: Identify sampling criteria for studies to be included (E.g., key variables, population, time frame, language, etc.) 3. Search for evidence in literature: Develop and implement a search strategy. 4. Evaluation of study quality: Appraisal process (i.e., a "good" study or a "bad" study) 5. Data extraction: Main findings, methods, and study characteristics for each study 6. Synthesize the evidence: Overall results from data of all the studies 7. Interpret/present the findings: Analyze, disseminate

What is a Meta-Analysis?

A technique for statistically integrating the results of multiple studies (that address the same or highly similar research question) Merges statistical findings from different experimental studies, yielding both information on the existence of a relationship between variables but also an estimate of the magnitude across studies Allows a researcher to develop recommendations for patient care and clinical practice

A forest plot portrays information about which of the following for each study in the meta- analysis? A) 95% CIs around an effect size B) Number of study participants C) Quality assessment scores D) Sample size and standard errors

A) 95% CIs around an effect size

Analysis of grey literature includes which forms of research? A) Dissertations, unpublished reports B) Peer-reviewed journals, funded research C) Systematic reviews, original research D) Research reports from electronic databases only

A) Dissertations, unpublished reports

Which of the following not only yields information about the existence of a relationship between variables in many studies but also an estimate of its magnitude? A) Effect size B) Problem formulation C) Grey literature D) Subgroup analysis

A) Effect size

Systematic reviews are the cornerstone of which of the following? A) Evidence-based practice B) Evidence hierarchies C) Meta-analyses D) Primary studies

A) Evidence-based practice

Which of the following is a condition under which meta-analysis would be inappropriate to conduct? A) Highly conflicting results among studies B) Research questions across studies being nearly identical C) A large number of studies to draw from D) Independent variables are similar across studies

A) Highly conflicting results among studies

It is appropriate to use statistical integration when which of the following components are nearly identical across studies? A) Independent variable, dependent variable, and study populations B) Statistical methods, population sample, hypotheses C) Dependent variable, research design, theory explication D) Available evidence, novel interpretation of findings, population sample

A) Independent variable, dependent variable, and study populations

Which of the following best defines metasyntheses? A) Involve interpretation as well as integration B) Involve meta-summaries C) Exclude studies judged to be low on trustworthiness D) Rely primarily on phenomenological primary studies

A) Involve interpretation as well as integration

Paterson and colleagues developed an approach to metasynthesis that includes which of the following components? Select all that apply. A) Meta-data analysis B) Meta-method C) Meta-ethnography D) Meta-theory

A) Meta-data analysis B) Meta-method D) Meta-theory

In this research question for a systematic review, the researchers use which approach to determining the answer to the question: Are clinical outcomes of nurse-led care for patients with rheumatoid arthritis similar to those produced by usual care? A) Randomized control trial B) Metasynthesis C) Meta-analysis D) Not a researchable question

A) Randomized control trial

An issue that is distinctive in nursing intervention research is which of the following? A) The development of an intervention theory B) The generation of data amenable for use in secondary analyses C) The inclusion of a methodological research component D) The use of a structure/process/outcomes framework

A) The development of an intervention theory

In metasyntheses, various methods are employed for interpretive analysis. One method developed by Paterson and a team of Canadian colleagues (2001) involves three components:meta-data analysis, meta-method, and meta-theory. A meta-data analysis involves which of the following? A) The study of the results of reported research in a specific substantive area by analyzing the "processed data" B) The study of the methodologic rigor of the studies included in the meta-synthesis C) The analysis of the theoretical underpinnings on which the studies are grounded D) The splitting of effect size information into distinct categorical groups

A) The study of the results of reported research in a specific substantive area by analyzing the "processed data"

Which of the following is most accurate regarding researchers conducting metasyntheses? A) They often conduct original studies on the same topic as the metasynthesis they are conducting. B) They perform little advance planning, as it is not needed in qualitative research. C) They make sampling decisions at the end of the study. D) They use only peer-reviewed journals in the analysis.

A) They often conduct original studies on the same topic as the metasynthesis they are conducting.

Searching for studies in the grey literature represents a reviewer's effort to do which of the following? Select all that apply. A) Counteract the effect of biases against the null hypothesis B) Increase sample size and therefore have a more comprehensive evidence base C) Minimize the risk of publication bias D) Include only published, peer-reviewed studies

A,B,C A) Counteract the effect of biases against the null hypothesis B) Increase sample size and therefore have a more comprehensive evidence base C) Minimize the risk of publication bias

Analyzing heterogeneity in meta-analysis can be visually attained with which of the following? A) Cohen's d B) A forest plot C) Inclusion criteria D) Moderator analyses

B) A forest plot

A viable approach to addressing the quality of primary studies included in a meta-analysis is which of the following? A) Ignoring the problem of quality by using all studies regardless of rigor B) Doing sensitivity analyses to assess if the effects change when low-quality studies are included. C) Using a random effects model rather than a fixed effects model. D) Using a forest plot to assess the degree to which study quality is related to effect size.

B) Doing sensitivity analyses to assess if the effects change when low-quality studies are included.

The use of both of qualitative and quantitative data in a study or cluster of studies serves the important purpose of which of the following? A) Providing researchers with different skills an opportunity to collaborate B) Enhancing the study's validity C) Allowing participants to select an unstructured or structured method of responding D) Enhancing the likelihood that the study will be published

B) Enhancing the study's validity

If a researcher wanted to assess how well an evidence-based protocol for encouraging adolescent mothers to breastfeed was meeting its objectives, the research would be which of the following? A) Survey B) Evaluation C) Methodologic research D) Secondary analysis

B) Evaluation

A widely-used approach to metasynthesis was developed by whom? A) Polit and Beck B) Noblit and Hare C) Glaser and Strauss D) Sackett and Cochrane

B) Noblit and Hare

The unit of analysis in a meta-analysis is which of the following? A) Individual study participants B) A primary qualitative study C) A primary quantitative study D) Prior systematic reviews

C) A primary quantitative study

Which of the following activities are normally undertaken as part of doing a meta-analysis? Select all that apply. A) Obtaining the original data set from primary study researchers B) Selecting a sample of studies C) Systematically extracting and recording data D) Evaluating the quality of studies

B,C,D B) Selecting a sample of studies C) Systematically extracting and recording data D) Evaluating the quality of studies

Meta-analysts depend on the calculation of an index that encapsulates in a single number the relationship between the independent and dependent variables in each study. An example of this calculation is which of the following? A) Inclusion criteria B) Forest plot C) Cohen's d D) Moderator analyses

C) Cohen's d

What type of study would address the following question: What barriers did the nursing staff face in implementing the fall prevention program? A) Impact analysis B) Outcomes study C) Process analysis D) Economic analysis

C) Process analysis

The integration of qualitative and quantitative approaches in a single study constitutes a form of which of the following? A) Hypothesis testing B) Theory generation C) Triangulation D) Methodologic research

C) Triangulation

When heterogeneity of effects is high (statistically significant), the preferred meta-analytic approach is which of the following? A) Abandon efforts to undertake a meta-analysis B) Use a fixed effects analytic model C) Use a random effects analytic model D) Use a forest plot to display the extensiveness of heterogeneity to readers of the report

C) Use a random effects analytic model

The unit of analysis in computing a frequency effect size, using the Sandelowski-Barroso approach, is which of the following? A) An individual study B) A study participant C) A mean value D) A theme or qualitative finding

D) A theme or qualitative finding

The "fruit" problem in meta-analysis refers to which of the following? A) Including studies in the analysis from multiple disciplines B) Including both unpublished and published reports in the analysis C) Including both qualitative and quantitative findings in the analysis D) Including studies that have addressed different research questions

D) Including studies that have addressed different research questions

Integrating and analyzing qualitative findings from multiple research studies is called which of the following? A) Systematic review B) Grey literature C) Meta-analysis D) Metasynthesis

D) Metasynthesis

Meta-analysts perform subgroup analyses to accomplish which of the following? A) Utilize a fixed effects model to ascertain heterogeneity B) Address publication bias and compute a fail-safe number C) Determine if exclusion criteria changes the results in a study D) Split the effect size information from studies into distinct categorical groups

D) Split the effect size information from studies into distinct categorical groups

In metasyntheses, various methods are employed for interpretive analysis. One method developed by Paterson and a team of Canadian colleagues (2001) involves three components: meta-data analysis, meta-method, and meta-theory. Meta-method involves which of the following? A) The study of the results of reported research in a specific substantive area by analyzing the "processed data" B) The splitting of effect size information into distinct categorical groups C) The analysis of the theoretical underpinnings on which the studies are grounded D) The study of the methodologic rigor of the studies included in the meta-synthesis

D) The study of the methodologic rigor of the studies included in the meta-synthesis

Conceptual Framework

Explains how the variables in a study are expected to relate to each other

3 types of systematic reviews:

Narrative review Meta-analysis Meta-synthesis

Key Advantages of Meta-Analysis (2)

Objectivity - statistical integration eliminates bias in drawing conclusions when results in different studies are at odds Power - the probability of detecting a true relationship between variables By combining effects across multiple studies, power is increased Sample size

Purposes of the Framework**

Provides direction for the study by providing an organized set of ideas/variables and their relationships Reveals conceptual and operational definitions Guides what data is to be collected and analyzed

Meta-analyses of ___________ are the "gold standard" of traditional evidence hierarchies

RCT's (randomized control trials"

Steps for Conducting a Meta-Synthesis

Similar process Problem/question formulation (PICO, SPICE) Design/conduct literature search Extraction of data Appraisal of studies Synthesize findings Presentation of findings

Systematic review qualities:

Systematic Rigorous Detailed Transparent

What is a is a cornerstone of Evidence-Based Practice (EBP)?

Systematic revews

What is a Meta-Synthesis? what does it offer?

Systematic review and integration of findings from inter-related qualitative studies Purpose and intent that's interpretive and not aggregating Offer new insights and interpretations

Systematic review

The systematic and rigorous integration and synthesis of evidence

An effect size index that can be used in meta-analyses includes which of the following? Select all that apply. A) Standardized mean difference or d B) Intensity effect size C) Pearson's correlation coefficient (r) D) The odds ratio (OR)

a c d A) Standardized mean difference or d C) Pearson's correlation coefficient (r) D) The odds ratio (OR)

conceptual frameworks is used when literature does not have

a specific theory that explains the relationship between study variables

Meta-analysis differs from meta-synthesis in that meta-analysis studies use which of the following? Select all that apply. A) Objectivity in drawing conclusions regarding a body of evidence B) Combining phenomena into a transformed whole C) Subjective decisions about how much weight to give findings from different studies D) A measure of the probability of detecting a true relationship between variables

a,d A) Objectivity in drawing conclusions regarding a body of evidence D) A measure of the probability of detecting a true relationship between variables

Heterogeneity can be examined using a

forest plot

effect size

quantifies the mangnitude and direction of the relationship between iv and dv in meta-analysis most common- d, odds ratio, correlation coefficient

what is a major issue in meta-analysis and affects decisions about which statistical model to use and whether a meta-analysis is justified?

statistical heterogeneity

a literature review with methodological and exhaustive examination of research evidence about a specific research question is a ?

systematic review

It is impossible to develop "best practice" guidelines, protocols, and procedures without finding and evaluating research evidence through?

through a systematic review