A Process Model for Evidence-Based Literature Syntheses

Dana N. Rutledge

Judith A. DePalma

Mary Cunningham

ONF 2004, 31(3), 543-550. DOI: 10.1188/04.ONF.543-550

Purpose/Objectives: To describe the development and implementation of the Triad Model of Research Synthesis, developed as a mechanism to produce systematic literature reviews that can serve as sources of evidence for decision making in health care.

Data Sources: Authors' recollections of the development and implementation process over a one-year period during 2002. Tracking forms were completed by members of three triad teams as they compiled research syntheses on clinical topics: pharmacologic treatment of dyspnea, assessment of sleep disturbances in patients with cancer, and exercise as an intervention for cancer-related fatigue.

Data Synthesis: The systematic literature review process includes the following steps: (a) organize, search the literature, and focus the research synthesis question; (b) critique the selected literature; (c) synthesize the evidence; and (d) write. On average, triad members spent hours that were equivalent to full-time work during the year (excluding completion of manuscripts) on the synthesis projects. Hours spent varied by member role and with each phase of the process.

Conclusions: Performing a research synthesis using the triad model was a productive and resource-intensive experience that points to the need for negotiating resources prior to embarking on such an exercise.

Implications for Nursing: Given a group of highly motivated nurses and others with adequate time and resources, this model can be effective when developing systematic reviews about a variety of topics. Literature syntheses developed can be used as evidence for clinicians and others to develop practice protocols and other evidence-based care guidelines.

Jump to a section

    References

    Briss, P.A., Zaza, S., Pappaioanou, M., Fielding, J., Wright-de Aguero, L., Truman, B.I., et al. (2000). Developing an evidence-based guide to Community Preventive Services—Methods. American Journal of Preventive Medicine, 18(1 Suppl.), 35-43.

    Cook, D.J., Guyatt, G.H., Byan, G., Clifton, J., Buchinham, L., Willan, A., et al. (1993). Should unpublished data be included in meta-analyses? Current convictions and controversies. JAMA, 269, 2739-2753.

    Cook, D.J., Mulrow, C., & Haynes, R.B. (1997). Systematic reviews: Synthesis of best evidence for clinical decisions. Annals of Internal Medicine, 126, 376-380.

    Cook, D.J., Mulrow, C., & Haynes, R.B. (1998). Synthesis of best evidence for clinical decisions. In C. Mulrow & D.J. Cook (Eds.)Systematic reviews: Synthesis of best evidence for health care decisions (pp. 1-4). Philadelphia: American College of Physicians.

    Cooper, H., & Hedges, L.V. (Eds.). (1994a). The handbook of research synthesis. New York: Russell Sage Foundation.

    Cooper, H., & Hedges, L.V. (1994b). Research synthesis as a scientific enterprise. In H. Cooper & L.V. Hedges (Eds.)The handbook of research synthesis (pp. 3-14). New York: Russell Sage Foundation.

    Craig, J.V., & Smyth, R.L. (Eds.). (2002). The evidence-based practice manual for nurses. Philadelphia: Churchill Livingstone.

    DePalma, J.A. (2000). Evidence-based clinical practice guidelines. Seminars in Perioperative Nursing, 9(3), 115-120.

    Droogan, J., & Cullum, N. (1998). Systematic reviews in nursing. International Journal of Nursing Studies, 35, 13-22.

    Earlam, S., Brecker, N., & Vaughan, B. (2000). Cascading evidence. Achieving skills in evidence-based practice. Philadelphia: Adis International.

    Evans, D., & Kowanko, I. (2000). Literature reviews: Evolution of a research methodology. Australian Journal of Advanced Nursing, 18(2), 33-38.

    Hadorn, D.C., Baker, D., Hodges, J.S., & Hicks, N. (1996). Rating the quality of evidence for clinical practice guidelines. Journal of Clinical Epidemiology, 49, 749-754.

    Haynes, B., & Haines, A. (1998). Barriers and bridges to evidence-based clinical practice. BMJ, 317, 273-276.

    Hearn, J., Feuer, D., Higginson, I.J., & Sheldon, T. (1999). Systematic reviews. Palliative Medicine, 13(1), 75-80.

    Lau, J., loannidis, J., & Schmid, C.H. (1998). Quantitative synthesis in systematic reviews. In C. Mulrow & D.J. Cook (Eds.)Systematic reviews: Synthesis of best evidence for health care decisions (pp. 91-102). Philadelphia: American College of Physicians.

    Lohr, K.N., & Carey, T.S. (1999). Assessing "best evidence" issues in grading the quality of studies for systematic reviews. Journal on Quality Improvement, 25, 470-479.

    Lynch, M.P. (2004). Progress and challenges in oncology advanced practice: The 2001 Oncology Nursing Society Advanced Practice Nursing Retreat. Oncology Nursing Forum, 31, 33-34.

    Mulrow, C., & Cook, D.J. (Eds.). (1998). Systematic reviews: Synthesis of best evidence for health care decisions. Philadelphia: American College of Physicians.

    Mulrow, C., Langhorne, P., & Grimshaw, J. (1998). Integrating heterogeneous pieces of evidence in systematic reviews. In C. Mulrow & D. J. Cook (Eds.)Systematic reviews: Synthesis of best evidence for health care decisions (pp. 103-112). Philadelphia: American College of Physicians.

    Newman, M., & Roberts, T. (2002). Critical appraisal 1. Is the study good enough for you to use findings? In J.V. Craig & R.L. Smyth (Eds.)The evidence-based practice manual for nurses (pp. 86-113). Philadelphia: Churchill Livingstone.

    Oxman, A.D., Cook, D.J., & Guyatt, G.H. (1994). Users' guides to the medical literature. VI. How to use an overview. JAMA, 272, 1367-1371.

    Ropka, M.E., & Spencer-Cisek, P. (2001). PRISM: Priority Symptom Management Project. Phase I—Assessment. Oncology Nursing Forum, 28, 1585-1594.

    Royal College of Nursing Institute. (1999). Clinical practice guidelines. The recognition and assessment of acute pain in children. Technical report. Appendix 1. Methods of obtaining papers and data extraction. London: Author.

    Rutledge, D.N., & Bookbinder, M. (2002). Processes and outcomes of evidence-based practice. Seminars in Oncology Nursing, 18, 3-10.

    Rutledge, D.N., & Grant, M. (2002). Evidence-based practice in cancer nursing. Introduction. Seminars in Oncology Nursing, 18, 1-2.

    Rutledge, D.N., Mooney, K.H., Grant, M., & Eaton, L. (2004). Implementation and refinement of a research utilization course for oncology nurses. Oncology Nursing Forum, 31, 121-126.

    Stetler, C.B., Morsi, D., Rucki, S., Broughton, S., Corrigan, B., Fitzgerald, J., et al. (1998). Utilization-focused integrative reviews in a nursing service. Applied Nursing Research, 11, 195-206.

    Wortman, P.M. (1994). Judging research quality. In H. Cooper & L.V. Hedges (Eds.)The handbook of research synthesis (pp. 97-109). New York: Russell Sage Foundation.