Ch 7

Question 1

Difficulties with Practicing Evidence-Based Practice

Answer 1

◦Constant demands on the time and resources available to clinicians
◦High quality literature is being published at too great a rate to be thoroughly analyzed by each practitioner.
◦Difficult for a clinician to remain unbiased in the evaluation of literature surrounding his or her question.
◦Tendency to appraise or find articles which support what was originally being sought.

Question 2

Critical reviews

Answer 2

A review sets out to analyze and summarize a specific subset of research information, and come to a conclusion based on the information included in the review.

Question 3

There are two main categories of quantitative review:

Answer 3

Narrative

Systematic

Question 4

Narrative

Answer 4

A gathering of information by an individual that may be considered an expert in the field.

Question 5

Systematic

Answer 5

A summary of the literature that uses clear methods to perform a thorough search and critical appraisal of individual studies.

Question 6

Meta analyses

Answer 6

A quantitative approach which contains a statistical summary of at least one outcome in two or more trials.

◦Results presented in graphic form.

Question 7

Critically Appraising Systematic Reviews

Answer 7

◦An art as well as a science
◦Many methods have been proposed - clinician can choose which is most useful
◦One example by the Centre for Evidence-Based Medicine contains a list of questions and a worksheet to help guide the process:
◦Are the results valid?
◦What are the results?
◦Will the results help me in caring for my patients?

Question 8

American National Library of Medicine (NLM)

Answer 8

electronic text-based search and retrieval system such as PubMed

Question 9

OVID/MEDLINE

Answer 9

enter keywords about your topic and limit the search to systematic reviews only

Question 10

OTseeker and PEDro

Answer 10

rehabilitation specific information

Question 11

Additional resources for systematic reviews

Answer 11

The Cochrane Collaboration

The Campbell Collaboration

Question 12

For qualitative research a “study of the processes and results of previous studies in a target domain that moves beyond those studies to situate historically, define for the present, and chart future directions in that domain. In meta-studies, the researcher seeks not only to combine the results from previous studies but also to reflect on them.” (Sandelowski & Barroso, 2003, p. 784-785

Answer 12

Metasynthesis

Question 13

Conducting a Metasynthesis

Answer 13

Finfgeld method = determine study focus —> sampling —> data analyses

Question 14

Critically Appraising Metasyntheses

Answer 14

Conduct of metasyntheses is still in its early stages.

◦No agreed method has been agreed upon.

Question 15

Characteristics to pay attention to in critically appraising metasyntheses:

Answer 15

1.Did the reviewers ask a clear question which is relevant to your clinical practice?
2.What was the rigor of the included studies?
3. Were the reviewers clear about their methods for analyzing data?
4. Was there a clear description of the similarities and differences between the primary studies?
5. Did the reviewer synthesize the studies in an understandable way?