I am delighted to be writing my first posting for the EBN Blog and would like to thank Roberta for getting it set up. I am looking forward to the Twitter journal club starting in the New Year.
Many of the commentaries we publish in EBN are about systematic reviews. The Research Made Simple paper published in July 2011 provides an overview of what a systematic review is (1). Systematic reviews are a useful way of identifying the current state of knowledge in a given area as well as areas for future research. The results can often challenge current policy and/or practices. For example, a recent systematic review concluded that routine general health checks do not decrease the likelihood of dying of cardiovascular disease or cancer (2).
I am currently in the middle of doing a systematic review. This has been much harder work than any of us on the team anticipated. Our first problem was that none of the studies we identified were randomised controlled trials. Many of them are chart audits or have used self-report tools such as questionnaires. This made it difficult to identify an appropriate critical appraisal tool. Eventually we came across a critical appraisal framework by Caldwell et al. that could be used for all the types of studies (3).
The second problem we have had is that because many of the studies have used chart reviews or self-report tools what we know about actual practices is limited. Data from a chart review, by its very nature, is limited by what has been documented. Self-report tools tell us what people think they do. Observational studies, on the other hand, provide data about what actually happens in practice. Having undertaken a couple of observation studies myself I am aware that the need to be in the clinical area for several hours a day is very time consuming. Indeed at times it feels as if the research is taking over your life. However, if we are really going to get a handle on what is happening in practice, nurse researchers maybe need to accept that chart audits and self-report tools are not robust enough.
(1) Clarke, J. (2011) What is a systematic review? Evidence Based Nursing 14(3), 64.
(2) Krogsball, L.T. et al. (2012) General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database of Systematic Reviews Issue 10.
(3) Caldwell, K. et al. (2011) Developing a framework for critiquing health research: An early evaluation. Nurse Education Today 31(8), e1-7.