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

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