Two texts have been chosen to address the PICOT question. Each of them is a peer-reviewed article published in a scholarly journal no later than five years ago. They represent systematic reviews and rely on the Level I evidence. The evaluation of each article separately can be found in Tables 1 and 2. The PICOT question is as follows:
- P – In obese populations;
- I – does using motivational interviewing to change eating habits;
- C – compared with traditional treatments;
- O – affect weight reduction among obese and overweight patients;
- T – over a period of one year?
Systematic Review and Meta-Analyses Evaluation Table 1
| Author(s): Barnes and Ivezaj. | Article: âA systematic review of motivational interviewing for weight loss among adults in primary careâ. |
| Validity of Results | |
| 1. What question did the systematic review address? Identify the research question. Did the review explicitly address a sensible question? Was main question clear and focused Did it describe the population, intervention, and outcomes of interest? | The systematic review addressed the issue of the motivational interviewing potential in affecting weight loss. Importantly, the research question intended to cover adult patients receiving primary care since this setting presented certain obstacles to effective weight loss (Barnes & Ivezaj, 2015). The review expanded the results of the previous research with the evidence from 19 studies. The main question was precise, and it covered all the significant aspects such as intended population, intervention, and results. |
| 2. Is it likely that all relevant studies (published and unpublished) were identified? Does the review include a detailed description of the search strategy to find all relevant studies? Was the search for relevant studies detailed and exhaustive? How was this determined? | The research includes exhaustive descriptions of search strategies including the databases that were considered and the method of refining search results. The combinations of different collocations to form the search have been provided for the reader to comprehend the way articles have been chosen from the multitude of resources (Barnes & Ivezaj, 2015). Therefore, it is possible to state that all relevant studies were identified. |
| 3. Were the criteria used to select articles for inclusion predetermined, clearly stated, and appropriate? Was the inclusion or exclusion of studies clearly defined a priori? Did the eligibility criteria specify the patients, interventions, outcomes, and study designs? | The research team considered randomized control trials as the relevant and reliable sources of evidence. However, other studies have also been reviewed at the initial stage. The eligibility criteria included patients receiving the intervention during primary care, and three important outcomes were researched, which included significant, insignificant, and no change in the weight of patients undergoing motivational interviewing. |
| 4. Were the included studies sufficiently valid? Were the primary studies of high methodologic quality? Are the studies contained in the review randomized controlled trials? Does the review describe how validity of the individual studies was assessed (e.g. methodological quality, including the use of random assignments to study groups and complete follow-up of the subjects)? | All the 24 studies were of sufficient methodological quality (Barnes & Ivezaj, 2015). Each of them was a randomized control trial. Importantly, one aspect was of the greatest significance in determining the quality, which was the statement on fidelity ratings. Some of the articles did not cover or were not specific enough for that matter, and the evidence from them was not included in compiling the systematic review. |
| 5. Were studies selected and data extracted by 2 or more individuals? Was there at least 2 independent selectors/extractors and a tie-breaking procedure for disagreements? | The article does not provide the information of that character. Therefore, it is impossible to state the number of people who extracted the data. In addition, no information on resolving disagreements was provided. |
| Results | |
| 6. Were the results similar from study to study? Identify the results. Where results of the included studies similar (homogeneous)? If heterogeneity exists, did the authors may estimate whether the differences are significant (chi-square test)? Were possible reasons for the heterogeneity explored? | The results were dissimilar. The researchers have identified three types of results. To be more precise, only 9 studies have evidenced a significant reduction in patientsâ weight while 13 researches found an indirect association between the minor weight loss and the application of the intervention (Barnes & Ivezaj, 2015). Notably, almost half of the studies displayed no shift in weight of patients experiencing motivational interviewing compared to those receiving traditional treatments. Nonetheless, the results within each subgroup were homogeneous. |
| 7. Was the risk of bias adequately assessed? Were tools used to assess quality of the studies identified? What likelihood ratios are associated with the range of possible test results? How large is the intervention or treatment effect (OR, RR, effect size, level of significance)? | The team has placed a particular emphasis on the risk of bias. They stated that âlimitations of the current study include publication bias or âfileâdrawer problemâ such that non-significant results tend not to be publishedâ (Barnes & Ivezaj, 2015, p. 13). Since this review did not include a meta-analysis, the ratios and the scale of intervention were not considered. |
| 8. Was a meta-analysis used How precise are the results? How precise is the intervention or treatment (CI)? | Meta-analysis was not used. The results are precise enough as they present the baseline sample characteristics and provide a summary of relevant results per each trial. The intervention is also precise since it follows a standardized approach. |
| Applicability | |
| Are the populations studied similar to my targeted population? Were all important outcomes considered? | The populations are similar, and the important outcomes are applicable to my targeted sample group (obese people). |
| Are the benefits worth the costs and potential risks? Were all clinically important outcomes considered, including risks and benefits of the treatment | According to the review results, the benefits are not precise. The introduction of the intervention might bring a positive improvement; however, half of the studies evidenced no significant change (Barnes & Ivezaj, 2015). Therefore, the usability of the intervention should be researched further. Nevertheless, the strategy implies no risk. |
Table 1. The review of the article written by Barnes and Ivezaj.
Systematic Review and Meta-Analyses Evaluation Table 2
| Author(s): OâHalloran, Blackstock, Shields, Holland, Iles, Kingsley, Bernhardt, Lannin, Morris, and Taylor. | Article: âMotivational interviewing to increase physical activity in people with chronic health conditions: A systematic review and meta-analysisâ. |
| Validity of Results | |
| 1. What question did the systematic review address? Identify the research question. Did the review explicitly address a sensible question? Was main question clear and focused Did it describe the population, intervention, and outcomes of interest? | The systematic review researched whether or not the method of motivational interviewing could influence positively the lifestyle choices of people with chronic illnesses such as obesity, cardiovascular illnesses and so on (OâHalloran et al., 2014). This query was reviewed in a clear and comprehensive manner, and it considered different aspects to this question. Importantly, the population for each disease was specified differently, but the intervention and the outcomes were similar. |
| 2. Is it likely that all relevant studies (published and unpublished) were identified? Does the review include a detailed description of the search strategy to find all relevant studies? Was the search for relevant studies detailed and exhaustive? How was this determined? | The research strategy was stated clearly. The team resorted to such databases as âMEDLINE, PsychINFO, EMBASE, AMED, CINHAL, SPORTDiscus and the Cochrane Central Register of Controlled trials” (OâHalloran et al., 2014, p. 1160). The authors have provided the search operators and key terms used to form the queries. In addition, when the articles have been selected, they were inspected by independent investigators for eligibility. |
| 3. Were the criteria used to select articles for inclusion predetermined, clearly stated, and appropriate? Was the inclusion or exclusion of studies clearly defined a priori? Did the eligibility criteria specify the patients, interventions, outcomes, and study designs? | The eligibility criteria were predetermined. The articles should have investigated patients with chronic conditions who should have received motivational interviewing in person and individually. The requested type of research was a randomized control trial (OâHalloran et al., 2014). The outcome should have included physical activity, cardiorespiratory fitness, and functional capacity. In addition, it was essential that the articles were published in full including the peer review process. |
| 4. Were the included studies sufficiently valid? Were the primary studies of high methodologic quality? Are the studies contained in the review randomized controlled trials? Does the review describe how validity of the individual studies was assessed (e.g. methodological quality, including the use of random assignments to study groups and complete follow-up of the subjects)? | The included studies were of different methodological quality; however, each of them was reliable. Only one article was assessed as undoubtedly high quality. As stated earlier, each study contained randomized control trials. To assess the validity of those, the research team has considered follow-ups. |
| 5. Were studies selected and data extracted by 2 or more individuals? Was there at least 2 independent selectors/extractors and a tie-breaking procedure for disagreements? | Two independent reviewers and extractors examined the studies and the extracted data. In the case of discrepancies, the extractors discussed the issue and the authors were contacted for clarification to avoid misunderstanding or confusion (OâHalloran et al., 2014). |
| Results | |
| 6. Were the results similar from study to study? Identify the results. Where results of the included studies similar (homogeneous)? If heterogeneity exists, did the authors may estimate whether the differences are significant (chi-square test)? Were possible reasons for the heterogeneity explored? | The results were similar from study to study and homogeneous (heterogeneity = 0%); they assumed only modest improvements in lifestyle choices of patients and evidenced no significant change in weight reduction (OâHalloran et al., 2014). Nevertheless, the authors stressed that the intervention did have a potential to affect weight reduction among obese and overweight patients. |
| 7. Was the risk of bias adequately assessed? Were tools used to assess quality of the studies identified? What likelihood ratios are associated with the range of possible test results? How large is the intervention or treatment effect (OR, RR, effect size, level of significance)? | Risk of bias was concluded to the quality of the reviewed researches. It was emphasized that some of the articles were of moderate quality and some researchers did not report the outcome measures. The intervention was rather large, and the effect size was either moderate or very low (in cardiorespiratory fitness). |
| 8. Was a meta-analysis used How precise are the results? How precise is the intervention or treatment (CI)? | The CI (95%) in obese populations was 52% post intervention (OâHalloran et al., 2014). In each of the intervention subcategories, the results have been presented. |
| Applicability | |
| Are the populations studied similar to my targeted population? Were all important outcomes considered? | The investigated populations are partly similar to my sample group. Therefore, only the evidence connected to obese populations can be considered for my research project. Nevertheless, all the significant outcomes have been provided for each group; therefore, the assumptions about patients suffering from obesity are applicable to my targeted population as well. |
| Are the benefits worth the costs and potential risks? Were all clinically important outcomes considered, including risks and benefits of the treatment | The clinically important outcomes include the statement that motivational interviewing does have the potential to affect weight reduction among obese and overweight patients. Nonetheless, this assumption implies that it is successful only when the practitioner incorporates the essential components of interviewing. In other cases, only modest improvements can be expected. Thus, the benefits are worth the costs if these guidelines are followed. Notably, no risks of the intervention have been projected. |
Table 2. The review of the article written by OâHalloran et al.
References
Barnes, R. D., & Ivezaj, V. (2015). A systematic review of motivational interviewing for weight loss among adults in primary care. Obesity Reviews, 16(4), 304-318.
OâHalloran, P., Blackstock, F., Shields, N., Holland, A., Iles, R., Kingsley, M.,…Taylor, N. (2014). Motivational interviewing to increase physical activity in people with chronic health conditions: A systematic review and meta-analysis. Clinical Rehabilitation, 28(12), 1159-1171.