Did they use a defensible and well-defined set of criteria, or a well-respected quality appraisal scale?

What question (PICO) did the systematic review address?

Did the report clearly state the research problem/question?
Is the topic important for nursing?
Were concepts and variables adequately defined?
Was integration approach adequately described?
Was integration approach appropriate?

F – Is it unlikely that important, relevant studies were missed?
Questions to answer
Did the report clearly describe criteria for selecting primary studies?
Were those criteria reasonable?
Were bibliographic databases used by reviewers identified?
Were the appropriated and comprehensive?
A – Were the criteria used to select articles for inclusion appropriate?
Were key words identified? Exhaustive?
Did reviewers use adequate supplementary efforts to identify relevant studies?
Was a flow chart included to summarize the search strategy and results?
Did the reviewers appraise the quality of the primary studies?

A – Were the included studies sufficiently valid for the type of question asked?
Did they use a defensible and well-defined set of criteria, or a well-respected quality appraisal scale?
Did two or more people do the appraisals, and was inter-rater agreement reported?
Was the appraisal information used in a well-defined and defensible manner in the selection of studies, or in
the analysis of results?

T – Were the results similar from study to study?
Was heterogeneity of effects adequately dealt with?
How are the results presented?
Was a meta-analysis performed? If not, was there adequate justification for using a narrative integration?

Far meta-analyses, were appropriate procedures followed for computing effect size estimates for all relevant
Was the decision to use a random effects model or a fixed effects model sound?
Were appropriate subgroup analyses undertaken-or was the absence of subgroup analyses justified?
Was the issue of publication bias adequately addressed?

Are the results valid?
Did the reviewers draw reasonable conclusions about the quality, quantity, and consistency of evidence relating
to the research question?
Were limitations of the review/synthesis noted?
Were implications for nursing and further research clearly stated?

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