course material

1. NRP/513-Nursing Clinical Applications of Theory and Research.
NRP/513-Nursing Clinical Applications of Theory and Research. NRP/513 v3: Clinical
Applications of Theory and ResearchGuidelines for Critiquing Systematic Reviews (Box
29.1)Instructions:This form color codes the criteria to separate questions which apply only
to systematic reviews of quantitative studies versus qualitative studies. Keep in mind, a
meta-analysis uses a different method for data analysis as compared to a systematic review
of a quantitativereport. NRP/513-Nursing Clinical Applications of Theory and
Research.ORDER A PLAGIARISM-FREE PAPER HEREFor each question, a "yes" response
indicates the strength of the study. If you answer "no," this is indication of a potential
problem. However, you must determine if the answer is "not applicable" first as not all
questions apply to all designs.Article: Gheorghe, A., Griffiths, U., Murphy, A., Legido-Quigley,
H., Lamptey, P., &Perel, P. (2018). The economic burden of cardiovascular disease and
hypertension in low- and middle-income countries: a systematic review. BMC Public Health,
18(1), 975. https://doi.org/10.1186/s12889-018-5806-x.Article Link:
http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mdc&AN=30081
871&site=eds-live&custid=uphoenixThe Problem• Did the report clearly state the research
problem and/or research questions? Is the scope of the project appropriate?No, the
research problem is implicitly stated as the lack of adequate information on the economic
burden of cardiovascular disease (CVD) in low- and middle- income countries (LMICs). The
scope of the project is appropriate. NRP/513-Nursing Clinical Applications of Theory and
Research.• Is the topic of the review important for nursing?Yes. The topic is relevant in
nursing because cardiovascular disease (CVD) is among the leading killer diseases globally.•
Were concepts, variables, or phenomena adequately defined?No. The concepts and
phenomena were not identified.• Was the integration approach adequately described, and
was the approach appropriate?No. The integration approach was not identified. NRP/513-
Nursing Clinical Applications of Theory and Research.Search Strategy• Did the report
clearly describe criteria for selecting primary studies, and are those criteria
reasonable?Yes• Were the bibliographic databases used by the reviewers identified, and are
they appropriate and comprehensive? Were key words identified, and are they
exhaustive?Yes. The databases included MEDLINE, MEDLINE In-Process and Other Non-
Indexed Citations (Ovid); EMBASE; NHS Economic Evaluation Database (NHSEED); EconLit;
Cochrane Central Register of Controlled Trials (CENTRAL); Cochrane Database of Abstracts
of Reviews of Effects (DARE); PsycInfo (Ovid); Latin American and Caribbean Health
Sciences Literature database (LILACS); MedCarib; Africa-Wide Information; Global Health;

2. Index Medicus for the South-East Region (IMSER); Index Medicus for the Eastern
Mediterranean Region (IMSEAR); Western Pacific Region Index Medicus (WPRIM); and the
New York Academy of Medicine Grey Literature Report. The databases were appropriate
and exhaustive.Keywords were Non-communicable disease, Cardiovascular disease,
Hypertension, Economic burden, Systematic review, Low-income, Middle-income. These
keywords were exhaustive.• Did the reviewers use adequate supplementary efforts to
identify relevant studies?Yes. The websites of the World Health Organization, the World
Bank, the World Economic Forum, and NCD Alliance for relevant reports. In addition, the
reference lists of included studies were hand-searched for further relevant sources.• Was a
PRISMA-type flowchart included to summarize the search strategy and results? NRP/513-
Nursing Clinical Applications of Theory and Research.YesThe Sample• Were inclusion and
exclusion criteria clearly articulated, and were they defensible?No. The inclusion and
exclusion criteria is broad and not definitive.• Did the search strategy yield a strong and
comprehensive sample of studies? Were strengths and limitations of the sample
identified?Yes. 83 studies were retrieved and included in the review and strengths and
limitations of the sample studies identified. NRP/513-Nursing Clinical Applications of
Theory and Research.• If an original report was lacking key information, did reviewers
attempt to contact the original researchers for additional information—or did the study
have to be excluded?No. it is not indicated.• If studies were excluded for reasons other than
insufficient information, did the reviewers provide a rationale for the decision?Yes. For
example, for examples literature reviews, policy papers, editorials, commentaries, opinion
pieces, and economic evaluation studies were extracted.Quality Appraisal• Did the
reviewers appraise the quality of the primary studies? Did they use a defensible and well-
defined set of criteria, or a respected quality appraisal scale?Yes. A seven-question quality
assessment tool was developed and used to assess the quality of the included studies.• Did
two or more people do the appraisals, and was interrater agreement reported?Two
independent reviewers performed title & abstract screening and excluded irrelevant
studies. However, the interrater agreement was no reported.• Was the appraisal
information used in a well-defined and defensible manner in the selection of studies, or in
the analysis of results?Yes. The appraisal information was applied to each study before it
was selected and included for analysis. NRP/513-Nursing Clinical Applications of Theory
and Research.Data Extraction• Was adequate information extracted about methodologic
and administrative aspects of the study? Was adequate information about sample
characteristics extracted?Yes. Data was extracted on the methodological characteristics of
studies and economic estimate. Data extraction was piloted using four studies.• Was
sufficient information extracted about study findings?Yes. The information extracted about
the findings of the study was adequate as it provided Key study characteristics and
economic findings as per the purpose of this review.• Were steps taken to enhance the
integrity of the dataset (e.g., were two or more people used to extract and record
information for analysis)?Yes. Two independent reviewers performed title & abstract
screening and full-text articles against the inclusion/exclusion criteria.Data Analysis—
General• Did the reviewers explain their method of pooling and integrating the data?Yes.
The data selection of the articles to be included was performed by two independent

3. reviewers and the quality of the included articles appraised using a seven-question quality
assessment tool specifically developed for this study• Was the analysis of data thorough and
credible?Yes. Management and analysis of the data was performed using Microsoft Excel
and R 3.1 statistical software. The data was analyzed basing on the general study
characteristics; methodological characteristics; and economic burden estimates. A narrative
synthesis was performed on the economic burden of CVD and hypertension and the current
research gaps.• Were tables, figures, and text used effectively to summarize findings?Yes.
The findings are represented using well labeled tables and figures.NRP/513-Nursing
Clinical Applications of Theory and Research.Data Analysis—Quantitative• If a meta-
analysis was not performed, was there adequate justification for using a narrative
integration method? If a meta-analysis was performed, was this justifiable?• For meta-
analyses, were appropriate procedures followed for computing affect size estimates for all
relevant outcomes?• Was heterogeneity of effects adequately dealt with? 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?Data Analysis—Qualitative• In a metasynthesis, did
the reviewers describe the techniques they used to compare the findings of each study, and
did they explain their method of interpreting their data?• If a metasummary was
undertaken, did the abstracted findings seem appropriate and convincing? Were
appropriate methods used to compute affect sizes? Was information presented effectively?•
In a metasynthesis, did the synthesis achieve a fuller understanding of the phenomenon to
advance knowledge? Do the interpretations seem well grounded? Was there enough data
included to support the interpretations? NRP/513-Nursing Clinical Applications of Theory
and Research. Conclusions• Did the reviewers draw reasonable conclusions about the
quality, quantity, and consistency of evidence relating to the research question?Yes. The
conclusions of the study were per the objective of the study. The authors concluded that the
economic impact of CVD and hypertension is significant relative to current health.• Were
limitations of the review/synthesis noted?Some grey literature sources may not have been
identified and studies were not excluded on the quality considerations and this may have
reduced the quality of the findings. NRP/513-Nursing Clinical Applications of Theory and
Research.• Were implications for nursing practice and further research clearly stated?Yes.
There is a need to strengthen the role ofeffective poolin, pre-paid contributions and
strategic purchasing to ensure that health systems have the ability to cope with the
increasing burden of CVD and NCDs. All systematic reviews/integrative reportsSystematic
reviews of quantitative studiesMetasynthesisWeek 8 Individual AssignmentYour committee
Chair is pleased with all the work done up to this point and is excited about the great strides
made over the last several weeks. Your Chair appreciates your consistent and detailed work
and has asked for your help to critique a systematic review.See systematic review study
(meta-analysis or other systematic review) Listed below. See attached article.Article:
Gheorghe, A., Griffiths, U., Murphy, A., Legido-Quigley, H., Lamptey, P., & Perel, P. (2018). The
economic burden of cardiovascular disease and hypertension in low- and middle-income
countries: a systematic review. BMC Public Health, 18(1), 975.Systemic Review
Study:Utilize the Critiquing a Systematic Review worksheet provided and respond to the

4. questions giving examples from the article. Make sure to include the article title and
associated link in the worksheet. See attached worksheet.NRP/513 v3: Clinical Applications
of Theory and ResearchGuidelines for Critiquing Systematic Reviews (Box
29.1)Instructions:This form color codes the criteria to separate questions which apply only
to systematic reviews of quantitative studies versus qualitative studies. Keep in mind, a
meta-analysis uses a different method for data analysis as compared to a systematic review
of a quantitativereport. NRP/513-Nursing Clinical Applications of Theory and Research.For
each question, a "yes" response indicates the strength of the study. If you answer "no," this
is indication of a potential problem. However, you must determine if the answer is "not
applicable" first as not all questions apply to all designs.Article: Gheorghe, A., Griffiths, U.,
Murphy, A., Legido-Quigley, H., Lamptey, P., &Perel, P. (2018). The economic burden of
cardiovascular disease and hypertension in low- and middle-income countries: a systematic
review. BMC Public Health, 18(1), 975. https://doi.org/10.1186/s12889-018-5806-x.Article
Link:
http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mdc&AN=30081
871&site=eds-live&custid=uphoenixThe Problem• Did the report clearly state the research
problem and/or research questions? Is the scope of the project appropriate?• Is the topic of
the review important for nursing?• Were concepts, variables, or phenomena adequately
defined?• Was the integration approach adequately described, and was the approach
appropriate? Search Strategy• Did the report clearly describe criteria for selecting
primary studies, and are those criteria reasonable?• Were the bibliographic databases used
by the reviewers identified, and are they appropriate and comprehensive? Were key words
identified, and are they exhaustive?• Did the reviewers use adequate supplementary efforts
to identify relevant studies?• Was a PRISMA-type flowchart included to summarize the
search strategy and results? NRP/513-Nursing Clinical Applications of Theory and
Research. The Sample• Were inclusion and exclusion criteria clearly articulated, and were
they defensible?• Did the search strategy yield a strong and comprehensive sample of
studies? Were strengths and limitations of the sample identified?• If an original report was
lacking key information, did reviewers attempt to contact the original researchers for
additional information—or did the study have to be excluded?• If studies were excluded for
reasons other than insufficient information, did the reviewers provide a rationale for the
decision? Quality Appraisal• Did the reviewers appraise the quality of the primary
studies? Did they use a defensible and well-defined set of criteria, or a respected quality
appraisal scale?• Did two or more people do the appraisals, and was interrater 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? Data Extraction• Was adequate
information extracted about methodologic and administrative aspects of the study? Was
adequate information about sample characteristics extracted?• Was sufficient information
extracted about study findings?• Were steps taken to enhance the integrity of the dataset
(e.g., were two or more people used to extract and record information for analysis)? Data
Analysis—General• Did the reviewers explain their method of pooling and integrating the
data?• Was the analysis of data thorough and credible?• Were tables, figures, and text used
effectively to summarize findings? Data Analysis—Quantitative• If a meta-analysis was

5. not performed, was there adequate justification for using a narrative integration method? If
a meta-analysis was performed, was this justifiable?• For meta-analyses, were appropriate
procedures followed for computing affect size estimates for all relevant outcomes?• Was
heterogeneity of effects adequately dealt with? 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? Data Analysis—Qualitative• In a metasynthesis, did the reviewers
describe the techniques they used to compare the findings of each study, and did they
explain their method of interpreting their data?• If a metasummary was undertaken, did the
abstracted findings seem appropriate and convincing? Were appropriate methods used to
compute affect sizes? Was information presented effectively?• In a metasynthesis, did the
synthesis achieve a fuller understanding of the phenomenon to advance knowledge? Do the
interpretations seem well grounded? Was there enough data included to support the
interpretations? Conclusions• 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 practice and
further research clearly stated? NRP/513-Nursing Clinical Applications of Theory and
Research.