APPENDIX C

Appraisal Guide

Conclusions of a Systematic Review with Narrative Synthesis

Citation:

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Synopsis

What organization or persons produced the systematic review (SR)?

How many persons were involved in conducting the review?

What topic or question did the SR address?

How were potential research reports identified?

What determined if a study was included in the analysis?

How many studies were included in the review?

What research designs were used in the studies?

What were the consistent and important across-studies conclusions?

Credibility

Was the topic clearly defined?  Yes   No   Not clear

Was the search for studies and other evidence comprehensive and unbiased?  Yes   No   Not clear

Was the screening of citations for inclusion based on explicit criteria?  Yes   No   Not clear

*Were the included studies assessed for quality?  Yes   No   Not clear

Were the design characteristics and findings of the included studies displayed or discussed in sufficient detail?  Yes   No   Not clear

*Was there a true integration (i.e., synthesis) of the findings—not merely reporting of findings from each study individually?  Yes   No   Not clear

*Did the reviewers explore why differences in findings might have occurred?  Yes   No   Not clear

Did the reviewers distinguish between conclusions based on consistent findings from several good studies and those based on inferior evidence (number or quality)?  Yes   No   Not clear

Which conclusions were supported by consistent findings from two or more good or high-quality studies? List

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Are the conclusions credible?  Yes All   Yes Some   No

Clinical Significance

*Across studies, is the size of the treatment or the strength of the association found or the meaningfulness of qualitative findings strong enough to make a difference in patient outcomes or experiences of care?  Yes   No   Not clear

Are the conclusions relevant to the care the nurse gives?  Yes   No   Not clear

Are the conclusions clinically significant?  Yes All   Yes Some   No

Applicability

Does the SR address a problem, situation, or decision we are addressing in our setting?  Yes   No   Not clear

Are the patients in the studies or a subgroup of patients in the studies similar to those we see?  Yes   No   Not clear

What changes, additions, training, or purchases would be needed to implement and sustain a clinical protocol based on these conclusions? Specify and list

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Is what we will have to do to implement the new protocol realistically achievable by us (resources, capability, commitment)?  Yes   No   Not clear

How will we know if our patients are benefiting from our new protocol? Specify

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Are these conclusions applicable to our setting?  Yes All   Yes Some   No

Should we proceed to design a protocol incorporating these conclusions?  Yes All   Yes Some   No

* = Important criteria

Comments

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APP C-2 Brown

Brown APP C-1

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