Literature Reviews

The literature Review

Comparing Systematic, Integrative, Meta-Analysis, Meta-Synthesis
Reviews of Literature
Systematic Reviews:


Complete unbiased collection of all original, quality studies addressing
same clinical problem

May contain meta-analysis,
Narrative analysis
Data Type

For all data types need to utilize quality checklists

Mixed-methods review

Takes ~ 1 year

Choice for EBP initiatives

Needs good clinical question

Explicit methods
Integrative Review:

Updated methodology,

Broadest review

Summarizes empirical, theoretical information, defines, reviews evidence

To more fully understand phenomena of concern

Data reported by table or diagrams
Allows diverse methodology usage

Can decrease rigor and increase bias

Cooper (1998) strategies to increase rigor

Potential to build science due to varied sample frames, various purposes, relevant healthcare problems,
Integrative of theoretical models>comprehensive!

Quantitative approach to synthesize evidence for therapeutic questions

Seeks new knowledge from existing data

Evidence from multiple, primary studies extracted, coded, and entered into database,
Can adjust for sample size
Statistical analysis to evaluate combined primary studies
(Potential to find significance in combining smaller studies)

^Objectivity, validity

Qualitative approach to synthesize evidence for therapeutic questions

Seeks new knowledge from existing data

Evidence from multiple, primary studies extracted, coded, and entered into database,
Can adjust for sample size
Goal to synthesize evidence

Complex process

Potential to ^ applicability of qualitative studies

Hemingway (2009) reports that healthcare information and dissemination has exploded with approximately 2 million articles being authored yearly. Increased healthcare knowledge is beneficial for providers and consumers alike, however, as with any explosion, the fallout can be enormous and confusion can ensue. With massive amounts of information, come the logical questions. What information is to be trusted? How can best practices, once discovered, be integrated into the health care system in a timely and efficient manner? Lastly and facetiously, when will more hours be added to the day so this enormous volume of data can be consumed, managed and integrated more efficiently?

Systematic reviews offer an organized, rigorous method to explore primary studies focused on a healthcare problem or topic. Qualitative or quantitative data is utilized to statistically address evidence-based practice initiatives. These reviews are rigorous and generally take a year to complete.

Integrative reviews are systematic reviews, which address an even broader scope of knowledge. Empirical, theoretical, quantitative and qualitative information can be reviewed and experimental or non-experimental studies can be summarized. Because of the vast array of different types of knowledge reviewed, this type of review has immense potential to enhance the exploration of various topics by giving a richer picture of the state of the evidence.

Meta-analysis is the statistical evaluation of primary quantitative studies, while meta-synthesis is the statistical evaluation of primary qualitative studies. The goal with both these review methods is to seek to identify new knowledge from existing data. Crombie and Davies (2009) point out that earlier usage of this type of inquiry could have demonstrated the effectiveness of thrombolytic therapy long before it was employed.

Utilizing these different reviews and analyses are complex processes. Rigor can decrease and bias increase if special care is not taken when obtaining and including studies. Cooper (1998) was instrumental in developing a process, which ensures a thorough inquiry (Whittemore & Knafl, 2005). First and foremost the problem is identified and an exhaustive literature search follows, this is accompanied by data extraction and analysis. The patterns that are identified are then presented, usually in a diagram or table format.

As research continues to provide new knowledge, usage of these types of analyses will become more common. It is essential that nurses are familiar with the reasons behind the different reviews and have the ability to assess if the information presented is sound.

In conclusion, it seems that the integrative review has the ability to provide a richer picture of the question or topic at hand. Since various methodologies are utilized and the data procured ranges from theoretical and empirical to quantitative and qualitative, this review method is very inclusive. However, by embracing the various methodologies and data types, rigor must be maintained with diligence and the usage of checklists.


Crombie, I. K., & Davies, H. T. (2009, April). What is meta-analysis? Retrieved from

Hemingway, P., & Brereton, N. (2009, April). What is a systematic review? Retrieved from

Walsh, D., & Downe, S. (2005). Meta-synthesis method for qualitative research: A literature review. Journal of Advanced Nursing, 50(2), 204-211.

Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553.

Literature Review