Question

Consider the purpose and process of meta-analysis or metasynthesis and how it informs evidence-based practice. How do recommendations made on the basis of these meta-analyses work to improve quality of care? Why would basing a practice change on one research article be unreliable?

Answer 1

Meta-analysis or Metasynthesis

It is method of integrating quantitative research findings statistically. In 1976, Glass coined the term Meta-analysis; it indicates analysis of analysis.

A meta-analysis statistically merges the outcome of various sutdies that hint a research hypthesis that is shared. A meta-analysis summarizes data from several individual studies that concern a specific research concern.

There is a growing interest in meta-synthesis as a technique for generating new insights and understanding from qualitative health care research. An increasing number of meta-synthesis papers are appearing in the nursing and midwifery literature.

Purpose of meta-analysis or metasynthesis

• Meta-anaysis is considered as the statistical analysis of a large amount of analysed results from individual studies for the purpose of integrating the findings.
• It is believed that the findings from each study individually may not be effective or poweful enough to allow for decisons affecting clinical practices. However, results of the several similar studies are analysed toghether, the findings or such studes may be more effective or powerful.
• Meta-analysis studies start with selecting studies with similar variables and population samples, followed by identifying and coding study characteristics, and finally statistically analysing and reporting the assessed findings of the meta-analysis study.

Why would basing a practice change on one research article be unreliable?

Meta-synthesis attempts to integrate results from a number of different but inter-related qualitative studies. The technique has an interpretive, rather than aggregating, intent, in contrast to meta-analysis of quantitative studies. Examples from the literature indicate that some aspects of the technique are not yet fully established.

How it informs evidence-based practice?

Meta-analysis combinies available information to generate an integrated result seems reasonable and can save a considerable amount of resources. Nowadays, meta-analyses are being used to design future research, to provide evidence in the regulatory process, and even to modify clinical practice.

How do recommendations made on the basis of these meta-analyses work to improve quality of care?

• Summarizes and integrate results from a number of individual studies
• Analyzes differences in the results among studies
• Overcomes small sample sizes of individual studies to detect effects of interest, and analyze end points that require larger sample sizes
• Increases precision in estimating effects
• Evaluates effects in subsets of patients
• Determines if new studies are needed to further investigate an issue
• Generates new hypotheses for future studies.

For eg: this design can be used for "a meta-analysis study on the coping behaviour of the people with cancer diagnosis". In this study, the researcher selects quantitative studies with coping behaviour of the people with cancer, which are conducted on the similar age groups, and later carry out a statistical anaysis on the results of the selected studies.

Therefore, quality of care can be improved through meta-analysis which provides the reasearcher with deepen understanding of the contextual dimensions of health care.