NURS 8310 WEEK 8 ASSIGNMENT: META-ANALYSIS
NURS 8310 WEEK 8 ASSIGNMENT: META-ANALYSIS
In epidemiology, meta-analyses are becoming a common research design. They are also “the most frequently cited form of clinical research,” and as such, are an essential type of study for the advanced practice nurse to be familiar with (Haidich, 2010).
For this Assignment, you will analyze a meta-analysis article and consider the implications of this research design for nursing practice, building on this week’s Discussion.
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- Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysisLinks to an external site.. European Journal of Cardiovascular Nursing, 17(1), 6–22. https://doi.org/10.1177/1474515117721561
- Seidler, A. L., Hunter, K. E., Cheyne, S., Berlin, J. A., Ghersi, D., & Askie, L. M. (2020). Prospective meta-analyses and Cochrane’s role in embracing next-generation methodologiesLinks to an external site.. Cochrane Database of Systematic Reviews, 10, ED000145. https://doi.org/10.1002/14651858.ED000145
- Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviewsLinks to an external site.. Journal of Clinical Epidemiology, 134, 178–189. https://doi.org/10.1016/j.jclinepi.2021.03.001
- Haidich, A. B. (2010). Meta-analysis in medical researchLinks to an external site.. Hippokratia, 14(Suppl. 1), 29–37. https://www.hippokratia.gr/images/PDF/14Sup1/699.pdf
- Melnyk, B. M., Kelly, S. A., Stephens, J., Dhakal, K., McGovern, C., Tucker, S., Hoying, J., McRae, K., Ault, S., Spurlock, E., & Bird, S. B. (2020). Interventions to improve mental health, well-being, physical health, and lifestyle behaviors in physicians and nurses: A systematic reviewLinks to an external site.. American Journal of Health Promotion, 34(8), 929–941. https://doi.org/10.1177/0890117120920451
- Siddaway, A. P., Wood, A. M., & Hedges, L. V. (2019). How to do a systematic review: A best practice guide for conducting and reporting narrative reviews, meta-analyses, and meta-synthesesLinks to an external site.. Annual Review of Psychology, 70, 747–770. https://doi.org/10.1146/annurev-psych-010418-102803
TO PREPARE:
- Using the Walden Library, locate a peer-reviewed article that utilizes a meta-analysis design and examines a population health topic that interests you. Your article must be a meta-analysis specifically, not just a systematic review.
ASSIGNMENT:
In 2–3 pages, not including title page and references, address the following:
- Identify your selected article. Explain what characteristics make this a meta-analysis.
- Were the inclusion and exclusion criteria clearly stated? How were the articles that were included selected? Do you agree with the researchers’ approach? Explain why or why not.
- Do you agree with the conclusions? Explain why or why not.
- Explain how you could apply implications from the study to your nursing practice.
Please use headings for each bullet above with details and examples. Thank you kindly for your assistance.
SEE THE GRADING RUBRIC BELOW
NURS_8310_Week8_Assignment_Rubric
| NURS_8310_Week8_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning OutcomeIn 2–3 pages, not including title page and references, address the following:Identify your selected article. Explain what characteristics make this a meta-analysis. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeWere the inclusion and exclusion criteria clearly stated? How were the articles that were included selected? Do you agree with the researchers’ approach? Explain why or why not. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeDo you agree with the conclusions? Explain why or why not. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeExplain how you could apply implications from the study to your nursing practice. |
|
25 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. |
|
5 pts | ||||
| Total Points: 100 | ||||||
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Week 8 Assignment: Meta-analysis
In epidemiological research, researchers must have comprehensive frameworks for developing foreground questions and exploring interactions between dependent and independent variables of interest. Zamzam et al. (2022) define scientific studies as “planned and systematic effort based on evidence for the solution of any health problems using data with a high degree of accuracy” (p. 1). Amidst the need to utilize data to solve health problems, study designs offer a “cascade” of steps relevant to formulating research questions, collecting data, and analyzing results.
Meta-analyses are among the vital research designs that inform research practices. According to Ahn & Kang (2018), a meta-analysis is an objective and valid scientific method of analyzing and combining results from multiple sources. The general organization of a meta-analysis study includes formulating a research question, protocol and registration, establishing inclusion and exclusion criteria, literature search and study selection, data extraction and analysis, and result presentation. Ahn & Kang (2018) argue that this research design provides a high level of evidence since it primarily entails an analysis of randomized controlled trials. Equally, meta-analyses effectively compare interventions and the precision of different instruments. Amidst the contribution of meta-analyses in epidemiological research, this paper analyzes a meta-analysis article on the effectiveness of weight management interventions for adults in primary care settings.
Identification of the Selected Article
The selected article is “Effective of weight management interventions for adults delivered in primary care: Systematic review and meta-analysis of randomized controlled trials” by Madigan et al. (2022). The study explores the effectiveness of behavioral weight management approaches for adults grappling with obesity in primary care. Adult obesity is a risk factor for multiple burdensome chronic conditions, including cancer, cardiovascular diseases (CVDs), and type 2 diabetes mellitus (T2DM). Further, Madigan et al. (2022) associate obesity and being overweight with adverse outcomes of COVID-19. Based on the association between obesity and various life-threatening conditions, it is valid to argue that this public health problem is the leading cause of premature mortality and disability-adjusted life years (DALYs) (Tekalegn et al., 2022). Consequently, this meta-analysis article derives inspiration from extensive research on non-pharmacologic interventions for weight management consistent with the need to prevent and treat adult obesity.
Characteristics that make it a Meta-analysis
A meta-analysis study consists of various characteristics, including a precise research question, eligibility criteria for the potential evidence sources, assessing the risk of bias, and an established statistical approach (Dekkers, 2018). Other elements of meta-analyses include literature search and study selection processes, data extraction and analysis sections, and result presentation. The selected article complies with the design thresholds for meta-analysis. For instance, it has a spelled-out clinical question and objective, eligibility criteria for selecting randomized controlled trials, a list of data sources (reputable databases), risk of bias assessment, data extraction, synthesis interventions, and a result presentation section. Also, the researchers included a section on outcome measures of the research, including primary and secondary outcomes. Consequently, it is an ideal example of a meta-analysis study.
The Inclusion and Exclusion Criteria
The meta-analysis study included 34 randomized controlled trials extracted from various databases, including Cochrane Central Register of Controlled Trials, Medline, PubMed, and PsychINFO. Initially, the researchers selected 111 studies in a previous review and 20333 records identified as studies. However, a rigorous appraisal process yielded 34 eligible RCT studies. According to Madigan et al. (2022), the inclusion criteria included the study’s aim, population, the evaluated intervention, and care settings. For instance, the researchers included randomized controlled trials that focused on weight loss as an intervention for preventing adult obesity, adults aged ≥18 who were candidates for weight loss interventions (selected based on a body mass index (BMI) higher than the normal range (≥25) or other weigh related measures, including weight circumstances), and studies conducted in primary care settings and delivered by a staff member of the primary care health team.
Other elements of inclusion criteria included a primary focus on behavioral interventions for weight loss, ≥12 months timing of the desired outcomes, and different comparisons, including no treatment, attention control, and minimal interventions comparable to usual care (Madigan et al., 2022). In this case, the researchers excluded studies that; explored primary prevention of overweight or obesity, treatment of cardiovascular disease, or treatment of cancer; studies limited to populations of general weight measurement; and those focused on alternative treatment interventions, including surgical and drug treatment and dietary supplements instead of behavioral weight management approaches (Madigan et al., 2022). Finally, the researchers excluded RCTs that are active comparators without control groups.
From a personal perspective, I agree with all elements of the inclusion and exclusion criteria because they allowed the researchers to objectively analyze evidence sources consistent with the need to develop an informed conclusion. Also, Inclusion and exclusion criteria enabled the researchers to align with the study objective of exploring the effectiveness of weight management interventions for adults delivered in primary care. For example, including studies that exclusively focus on adults aged ≥18 and population selected based on a body mass index (BMI) higher than the normal range (≥25) allowed researchers to explore the intervention’s outcomes on the study population within the specified time (≥12 months of intervention or baseline assessment). Therefore, strict inclusion and exclusion criteria contributed to time management and the subsequent avoidance of information overload or the need to review studies with inconsistent findings.
The Study’s Conclusion
Based on a comprehensive review of the eligible 34 randomized controlled trials, the researchers concluded that behavioral management interventions for adults with obesity are effective for weight loss. I agree with this conclusion since it is justifiable by current, reliable, and valid scholarly literature. According to Madigan et al. (2022), this conclusion was based on a large sample of about 8000 participants across the reviewed 34 randomized controlled trials. 12 out of the 34 studies provided up-to-date information regarding the topic since they were published in 2018. Although researchers encountered limitations like the inability to examine the equity of interventions, the study’s conclusion is consistent with findings from other research works. In a literature review on the effectiveness of behavioral weight management interventions in preventing adult obesity, Curry et al. (2018) reveal a significant impact of weight loss maintenance strategies like self-monitoring of weight, exercise videos, and food scales in reducing unhealthy weight. This study justifies the conclusion by Madigan et al. (2022) regarding the effectiveness of behavioral weight management interventions in preventing and treating adult obesity.
Implications of the Study
The study recommends delivering behavioral weight management interventions in primary care settings and reflecting on resource availability within primary care before delivering weight management approaches. Also, Madigan et al. (2022) propose adequate training for primary care practitioners to ensure the successful implementation of weight management strategies in primary care settings. These recommendations are consistent with the need to ensure the equity of interventions and eliminate disparities when helping adults with obesity to manage their weight (Madigan et al., 2022). Based on a large sample (over 8000 participants) and a comprehensive review of recent randomized controlled trials (RCTs) that evaluate the impacts of weight management interventions in preventing and treating adult obesity, the meta-analysis study’s findings are reliable, valid, and transferable to other clinical contexts.
From a personal perspective, I agree with the implications of the meta-analysis study since it reveals the effectiveness of behavioral weight management approaches in preventing and treating adult obesity. Also, it identifies the intricacies and requirements for generalizing these interventions in other clinical contexts. By reviewing resource availability in clinical settings and training healthcare professionals, it is possible to help obese patients to manage their weight and alleviate the subsequent adverse complications associated with being overweight and obese, including a high risk of cancer, cardiovascular conditions, and type 2 diabetes.
Conclusion
Meta-analyses provide a high level of evidence and are profound research designs for epidemiologic research. The reviewed scholarly article aligns with various characteristics of a meta-analysis, including established inclusion and exclusion criteria, a well-spelled-out clinical question, risk of bias assessment, data extraction and analysis, and result presentation. Secondly, it provides evidence-based insights into the effectiveness of behavioral weight management interventions in preventing and treating adult obesity. By establishing strict inclusion and exclusion criteria and comprehensively analyzing the selected evidence sources, meta-analyses studies yield reliable, valid, precise, and generalized findings that inform conclusions regarding different epidemiological research topics.
References
Ahn, E., & Kang, H. (2018). Introduction to systematic review and meta-analysis. Korean Journal of Anesthesiology, 71(2), 103–112. https://doi.org/10.4097/kjae.2018.71.2.103
Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Grossman, D. C., Kemper, A. R., Kubik, M., Landefeld, C. S., Mangione, C. M., Phipps, M. G., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2018). Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults. JAMA, 320(11), 1163–1171. https://doi.org/10.1001/jama.2018.13022
Madigan, C. D., Graham, H. E., Sturgiss, E., Kettle, V. E., Gokal, K., Biddle, G., Taylor, G. M. J., & Daley, A. J. (2022). Effectiveness of weight management interventions for adults delivered in primary care: Systematic review and meta-analysis of randomized controlled trials. BMJ, 377, e069719. https://doi.org/10.1136/bmj-2021-069719
Tekalegn, Y., Solomon, D., Sahiledengle, B., Assefa, T., Negash, W., Tahir, A., Regassa, T., Mamo, A., Gezahegn, H., Bekele, K., Zenbaba, D., Tasew, A., Desta, F., Atlaw, D., Regassa, Z., Nugusu, F., Engida, Z. T., Tesfaye, D. G., Kene, C., & Nigussie, W. S. (2022). Prevalence of central obesity and its associated risk factors among adults in Southeast Ethiopia: A community-based cross-sectional study. PLOS ONE, 17(8), e0265107. https://doi.org/10.1371/journal.pone.0265107
Zamzam, S. M., Abdel-Aziz, M., Atef, A., Abdel-Naseer, U., Hamoda, M., Salah, M., Dewidar, H., Elsharkawy, L., Fawzy, M., Shabana, M., Elkhosht, M., Eldesouky, H., & Hamdy, H. S. (2022). Study designs and research methodology in the field of otolaryngology. The Egyptian Journal of Otolaryngology, 38(1), 1–5. https://doi.org/10.1186/s43163-022-00264-4
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