A systematic review should address the components specified in PICOS. Why is this so? (Select all that apply.)
a. Interventional research always uses some means of comparison.
b. "Interventions" that are actually naturally occurring conditions should be noted, since they decrease confirmatory power of the collective evidence.
c. Study design is essential, since recommendations for change in practice can be based only on some designs.
d. Desired outcomes, not actual outcomes of the study, are the focus of the review.
e. The specific population from which a sample was drawn, and its similarity to those of others studies reviewed, affects generalizability.
ANS: A, B, C, E
A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to address a health care question. A systematic review involves identifying, locating, appraising, and synthesizing quality research evidence for expert clinicians to use to promote an EBP. Systematic reviews are often conducted by two or more researchers and/or clinicians in a selected area of interest to determine the best research knowledge in that area. Systematic reviews need to be conducted with rigorous research methodology to promote the accuracy of the findings and minimize the reviewers' bias. A systemic review or meta-analysis is best directed by a relevant clinical question that focuses the review process and promotes the development of a quality synthesis of research evidence. One of the most common formats used to organize a systematic review is the PICO or PICOS format described in the Cochran Handbook. PICOS are (1) population (or sample), (2) intervention, (3) comparison group or condition, (4) outcomes, and (5) study design. Naturally occurring "interventions" indicate a non-interventional design; the researcher enacts the research intervention.
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