Critiquing an Integrated Review
An integrative review or overview results from the analysis and synthesis of research studies on a specific topic. Below are attributes of integrative reviews that indicate good quality of analysis and synthesis and usefulness in determining evidence-based practice. Reviews will usually not contain all of these characteristics (Whittemore & Knafl, 2005; Whittemore, 2005)
- Group, not individual, involvement in review processes.
- Description of how studies were chosen and from what databases; reflects thorough and appropriate search.
- Focused selection of studies.
- Use of specific ratings of evidence strength; includes criteria used to analyze scientific merit.
- A guiding framework (e.g., research utilization).
- Focused description of studies (can be in tables).
- Inclusion of tables that include critical information relative to applicability.
- Conclusions follow logically from analysis.
- Differentiates between clinical and statistical significance.
Based upon the quality of the review, the critiquer who wants to provide evidence for practice must answer the following questions:
- What are the findings from the review? How precise are they? Were results similar from study to study?
- Was there a clear result related to a particular intervention or was there a consistent relationship found between variables?
- If results were not consistent across studies, what could explain the differences in results?
- Do the results of the review help in answering patient care questions?
- Were there any patient outcomes that were not addressed in the review?
- Are the benefits of the recommended intervention(s) worth the harms and costs?
- Describe the key elements/features of the approach or intervention.
- Do the findings/conclusions of the review succeed in making you wanting to make a practice change?
Published evaluation tools (Stetler, et al. 1998, pp. 198-199; Brown, 1999, pp.239-240) exist for appraising integrative reviews.
Continue to Step 3.6 - Critiquing Clinical Practice Guidelines