Heart & Lung 43 (2014) 577e578
Contents lists available at ScienceDirect
Heart & Lung journal homepage: www.heartandlung.org
Letters to the Editor
To the readers of Heart & Lung Reviews of knowledge synthesis play an important role in today’s evidence based health care decision making.1 Summarizing the evidence in certain areas or about specific topics enables the user to assess, maintain and improve the quality of health care delivery in a variety of sectors including research, practice and policy. Quantitative evidence syntheses in the form of systematic reviews that may or may not include meta-analyses are frequently conducted and have influenced health care delivery over the last decade.2 Synthesis of qualitative data and its inclusion in systematic reviews remains difficult since a variety of methodologies, methods and ways to analysis exist.3 The conduct of reviews of mixed evidence synthesis has been even more problematic due to clashes of quantitative and qualitative methodologies, a discourse also known as the paradigm “war.”4 Outcome driven approaches may have helped to overcome some of these problems as mixed evidence synthesis reviews are now frequently published alongside quantitative systematic reviews.2,5 In the latest publication of Heart & Lung, Whittemore et al present an interesting and useful overview of approaches to quantitative, qualitative and mixed evidence synthesis.6 The authors highlight the epistemological, methodological and methodical challenges of quantitative, qualitative and mixed evidence synthesis and present a variety of possible approaches, methods and standards of reporting.6 In this regard, I would like to point the reader to two important reporting standards not explicitly referred to by Whittemore et al. The RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project aims to “ensure that users of reviews are provided with relevant and necessary information to enable them to assess the quality and rigor of a review.”7,8 The results are two quality standards for the reporting of realist syntheses and meta-narrative reviews that guide researchers, peer-reviewers and funders/commissioners that are concerned with the methodological rigor of such reviews.9 Standards that guide qualitative and mixed evidence synthesis are in demand and will strengthen the inclusion of qualitative evidence into systematic reviews which will in turn improve health care decision making and the overall quality of health care delivery. A milestone in this regard may be the recent publication of the first review of qualitative evidence synthesis by the Cochrane Collaboration.10 References 1. Fineout-Overholt E, O’Mathuna DP, Kent B. How systematic reviews can foster evidence-based clinical decisions. Worldviews Evid Based Nurs. 2008;5(1):45e48. 0147-9563/$ e see front matter Ó 2014 Elsevier Inc. All rights reserved.
2. Norman I, Griffiths P. The rise and rise of the systematic review. Int J Nurs Stud. Jan 2014;51(1):1e3. 3. Barnett-Page E, Thomas J. Methods for the synthesis of qualitative research: a critical review. BMC Med Res Methodol. 2009;9:59. 4. Griffiths P, Norman I. Qualitative or quantitative? Developing and evaluating complex interventions: time to end the paradigm war. Int J Nurs Stud. May 2013;50(5):583e584. 5. Hallberg IR. Moving nursing research forward towards a stronger impact on health care practice? Int J Nurs Stud. Apr 2009;46(4):407e412. 6. Whittemore R, Chao A, Jang M, Minges KE, Park C. Methods for knowledge synthesis: an overview. Heart Lung. 2014;43(5):453e461. 7. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: meta-narrative reviews. J Adv Nurs. May 2013;69(5): 987e1004. 8. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: realist syntheses. J Adv Nurs. May 2013;69(5):1005e1022. 9. Wong G, Greenhalgh T, Westhrop G, Pawson R. The RAMESES (Realist and Meta-narrative Evidence Syntheses: Evolving Standards) Project, http://www. ramesesproject.org/; 2014. 10. Gulmezoglu AM, Chandler J, Shepperd S, Pantoja T. Reviews of qualitative evidence: a new milestone for Cochrane. Cochrane Database Syst Rev. 2013;11: ED000073.
DOI of original article: http://dx.doi.org/10.1016/j.hrtlng.2014.05.014 Ralph Tramm, PhD Scholar, RN, Dip (Nursing), BSc, PGDip (ICU), MAppSc (Research)* Department of Epidemiology and Preventive Medicine (DEPM) Australian and New Zealand Intensive Care Research Centre (ANZIC RC), Monash University Melbourne, Victoria 3004, Australia * Corresponding author. Tel.: þ61 3 990 30932. E-mail address: [email protected] http://dx.doi.org/10.1016/j.hrtlng.2014.08.001
Reply to Letter to the Editor We thank Mr. Tramm for the insightful comments and appreciate the opportunity to engage in dialogue with other researchers interested in the topic of knowledge synthesis. We agree about the increasing importance of knowledge synthesis for research, practice, and policy, and the challenges of conducting these syntheses. Our paper, Methods for Knowledge Synthesis: An Overview (Whittemore et al, 2014), provides a synopsis and primer of methodologies and guidelines available to authors; however, it is not an exhaustive list. We included well-established methods as well as more recent approaches. We thank Mr. Tramm for sharing two additional and relatively new methods for realist and meta-narrative syntheses. This highlights the growth and progression of knowledge synthesis methods. The emergence of different types of knowledge
Contents lists available at ScienceDirect
Heart & Lung journal homepage: www.heartandlung.org
Letters to the Editor
To the readers of Heart & Lung Reviews of knowledge synthesis play an important role in today’s evidence based health care decision making.1 Summarizing the evidence in certain areas or about specific topics enables the user to assess, maintain and improve the quality of health care delivery in a variety of sectors including research, practice and policy. Quantitative evidence syntheses in the form of systematic reviews that may or may not include meta-analyses are frequently conducted and have influenced health care delivery over the last decade.2 Synthesis of qualitative data and its inclusion in systematic reviews remains difficult since a variety of methodologies, methods and ways to analysis exist.3 The conduct of reviews of mixed evidence synthesis has been even more problematic due to clashes of quantitative and qualitative methodologies, a discourse also known as the paradigm “war.”4 Outcome driven approaches may have helped to overcome some of these problems as mixed evidence synthesis reviews are now frequently published alongside quantitative systematic reviews.2,5 In the latest publication of Heart & Lung, Whittemore et al present an interesting and useful overview of approaches to quantitative, qualitative and mixed evidence synthesis.6 The authors highlight the epistemological, methodological and methodical challenges of quantitative, qualitative and mixed evidence synthesis and present a variety of possible approaches, methods and standards of reporting.6 In this regard, I would like to point the reader to two important reporting standards not explicitly referred to by Whittemore et al. The RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project aims to “ensure that users of reviews are provided with relevant and necessary information to enable them to assess the quality and rigor of a review.”7,8 The results are two quality standards for the reporting of realist syntheses and meta-narrative reviews that guide researchers, peer-reviewers and funders/commissioners that are concerned with the methodological rigor of such reviews.9 Standards that guide qualitative and mixed evidence synthesis are in demand and will strengthen the inclusion of qualitative evidence into systematic reviews which will in turn improve health care decision making and the overall quality of health care delivery. A milestone in this regard may be the recent publication of the first review of qualitative evidence synthesis by the Cochrane Collaboration.10 References 1. Fineout-Overholt E, O’Mathuna DP, Kent B. How systematic reviews can foster evidence-based clinical decisions. Worldviews Evid Based Nurs. 2008;5(1):45e48. 0147-9563/$ e see front matter Ó 2014 Elsevier Inc. All rights reserved.
2. Norman I, Griffiths P. The rise and rise of the systematic review. Int J Nurs Stud. Jan 2014;51(1):1e3. 3. Barnett-Page E, Thomas J. Methods for the synthesis of qualitative research: a critical review. BMC Med Res Methodol. 2009;9:59. 4. Griffiths P, Norman I. Qualitative or quantitative? Developing and evaluating complex interventions: time to end the paradigm war. Int J Nurs Stud. May 2013;50(5):583e584. 5. Hallberg IR. Moving nursing research forward towards a stronger impact on health care practice? Int J Nurs Stud. Apr 2009;46(4):407e412. 6. Whittemore R, Chao A, Jang M, Minges KE, Park C. Methods for knowledge synthesis: an overview. Heart Lung. 2014;43(5):453e461. 7. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: meta-narrative reviews. J Adv Nurs. May 2013;69(5): 987e1004. 8. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: realist syntheses. J Adv Nurs. May 2013;69(5):1005e1022. 9. Wong G, Greenhalgh T, Westhrop G, Pawson R. The RAMESES (Realist and Meta-narrative Evidence Syntheses: Evolving Standards) Project, http://www. ramesesproject.org/; 2014. 10. Gulmezoglu AM, Chandler J, Shepperd S, Pantoja T. Reviews of qualitative evidence: a new milestone for Cochrane. Cochrane Database Syst Rev. 2013;11: ED000073.
DOI of original article: http://dx.doi.org/10.1016/j.hrtlng.2014.05.014 Ralph Tramm, PhD Scholar, RN, Dip (Nursing), BSc, PGDip (ICU), MAppSc (Research)* Department of Epidemiology and Preventive Medicine (DEPM) Australian and New Zealand Intensive Care Research Centre (ANZIC RC), Monash University Melbourne, Victoria 3004, Australia * Corresponding author. Tel.: þ61 3 990 30932. E-mail address: [email protected] http://dx.doi.org/10.1016/j.hrtlng.2014.08.001
Reply to Letter to the Editor We thank Mr. Tramm for the insightful comments and appreciate the opportunity to engage in dialogue with other researchers interested in the topic of knowledge synthesis. We agree about the increasing importance of knowledge synthesis for research, practice, and policy, and the challenges of conducting these syntheses. Our paper, Methods for Knowledge Synthesis: An Overview (Whittemore et al, 2014), provides a synopsis and primer of methodologies and guidelines available to authors; however, it is not an exhaustive list. We included well-established methods as well as more recent approaches. We thank Mr. Tramm for sharing two additional and relatively new methods for realist and meta-narrative syntheses. This highlights the growth and progression of knowledge synthesis methods. The emergence of different types of knowledge
