Question 1:The Problem
Did the report state the research problem and/or research questions? Is the scope of the project appropriate? Was the approach to integration described, and was the approach appropriate?
Question 2: Search Strategy
Did the report describe criteria for selecting primary studies, and are the criteria defensible?
Were the bibliographic databases used by the reviewers identified, and are they appropriate and comprehensive? Were key words identified?
Did the reviewers use supplementary efforts to identify relevant studies?
Question 3: The Sample
Did the search strategy yield a good sample of studies?
If a primary study report was lacking key information, did reviewers attempt to contact the original researchers for additional information?
Question 4: Quality Appraisal
Did the reviewers appraise the quality of the primary studies? Did they use a well-defined set of criteria or a validated quality appraisal scale?
Did two or more people do the appraisals, and was interrater reliability reported?
Was quality information used effectively in selecting studies or analyzing results?
Question 5: Data Extraction
Was adequate information extracted about the study design, sample characteristics, and study findings?
Were steps taken to enhance the integrity of the data set (e.g., Were two or more people used to extract and record information for analysis)?
Question 6: Data Analysisâ€”General
Did the reviewers explain their method of pooling and integrating the data?
Were tables, figures, and text used effectively to summarize findings?
Question 7: Data Analysisâ€”Quantitative
If a meta-analysis was not performed, was there adequate justification for using narrative integration? If a meta-analysis was performed, was this justifiable?
For meta-analyses, did the report describe how effect sizes were computed?
Was heterogeneity of effects assessed? Was the decision to use a random effects model versus a fixed effects model sound? Were subgroup analyses undertakenâ€”or was the absence of subgroup analyses justified?
Question 8: Conclusions
Did the reviewers draw reasonable conclusions about their results and about the quality of evidence relating to the research question?
Were limitations of the review/synthesis noted?
Were implications for nursing and health care practice and further research clearly stated?