Analyzing Consumer Priorities for Hospital End-of-Life Care Using a Systematic Review to Inform Policy and Practice

Abstract

4 A systematic review is a useful method to answer a research question where prior studies have been conducted. A well-designed and executed systematic review can inform policy and/or practice change. It can also identify gaps and generate new research questions. While the requirements considered essential for conducting a rigorous systematic review are well defined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, the approaches taken to synthesise the data vary. This case study describes the narrative synthesis of heterogeneous quantitative studies and the meta-synthesis of qualitative studies used to answer a complex research question from the consumer perspective. The study design focused on the analysis of consumer data only. As a result, the synthesis of both quantitative data and qualitative data have provided a detailed insight into consumers' unique perspectives and needs. The synthesis approach for both datasets is described, and linkages to key tools and resources to help facilitate this approach are provided. Processes used by the research team to enable effective research governance and collaboration throughout are also detailed. Learning OutcomesBy the end of this case students should be able to: Define a systematic review and outline the key elements required to ensure a review is rigorous; Outline practical suggestions on how to systematically source and manage data to answer a defined research question;  Consider how to design a study to represent the appropriate population through careful data extraction and synthesis techniques; Therefore, our team discussed how we might answer our research question with a specific focus on whether we would conduct another primary study or look to research already completed.On discussion, the team agreed that given significant work had already been completed on this question, a rigorous review of such work would be the most effective method to inform our next steps. Therefore, we chose to conduct a systematic review of published peer-reviewed literature to extract the relevant data, synthesise these data and present our findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The PRISMA statement outlines an evidence-based minimum set of items for reporting within a systematic review to enable a quality review (Moher, Liberati, Tetzlaff, & Altman, 2009). Importantly, our review was designed to rely on consumer data only with this design evident within eligibility criteria, data extraction and synthesis."A systematic review is a review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyze data from the studies that are included in the review." (Moher et al., 2009, p. 334) In the era of evidence-based medicine, systematic reviews are required to adhere to the same rigorous methodological standards as primary studies. The subjective n...