Critical Commentary of Article 1

The ENTREQ statement (Tong et al. 2012) was used to guide a critical commentary of the published article presented in this chapter. The aim of the ENTREQ statement is clearly stated in its own name "Enhancing

transparency in reporting the synthesis of qualitative research (ENTREQ)". It has no scoring system but provides a checklist of items which the authors

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suggest should be addressed when reporting a literature review of qualitative studies.

Assessing the quality of qualitative research is difficult and contentious (Pope & May 2000) as there is little evidence that the quality of reporting reflects the trustworthiness of the findings or the robustness of the study (Dixon- Woods et al. 2007). The aim of the ENTREQ statement is to enhance the reporting of qualitative syntheses (reviews) which will allow the reader to better understand the conduct of the study and processes of the synthesis. The authors accept that it is unlikely that there will ever be standardised reporting guidelines so instead have produced a checklist for consideration when undertaking and reporting review.

The literature review satisfactorily addressed many of the relevant areas identified in the checklist, some of which were reported in the article, and some that were undertaken during the process but not reported (See Table 1.1 for the ENTREQ statement and completed assessment). Possibly the most significant omission was the lack of use of an appraisal tool (item 11 in the checklist) during the review. (This issue has since been addressed and reported earlier in this chapter.)

Items 18 and 19 were not fully addressed (See Table 1.1). Being explicit about the way in which the synthesis occurred would have enhanced the transparency of the review. The purpose of the review firmly directed the information being sought. Each article was read with the specific aim of identifying the current evidence regarding the information needs, its

presentation and the decision-making preferences of older women faced with a treatment option for breast cancer. Findings were then categorised into themes. The findings from each article were then compared across others in the same theme.

Item 21 was similarly not fully addressed however the purpose of the review was as described above and therefore it did not require this level of analysis. This review was undertaken with a strong emphasis on the findings being of practical application in healthcare and this was achieved

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Table 2.1: The ENTREQ statement

Review of "Information Needs of Older Women Faced with a Choice of Primary Endocrine Therapy or Surgery for Early-Stage

Breast Cancer: A Literature Review"

No Item Guide and description Article Review

1 Aim State the research question the synthesis addresses.

Purpose of the review clearly stated

2 Synthesis methodology Identify the synthesis methodology or theoretical framework which underpins the synthesis, and describe the rationale for choice of methodology

The rationale for the choice of methodology i.e. the type of review undertaken, a

systematic search and review' was not stated in the paper.

3 Approach to searching Indicate whether the search was pre-planned (comprehensive search strategies to seek all available studies) or iterative (to seek all available concepts until they theoretical saturation is

achieved).

The search was pre-planned and aimed to identify all available studies.

4 Inclusion criteria Specify the inclusion/exclusion criteria (e.g. in terms of population, language, year limits, type of

Inclusion and exclusion criteria were reported.

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No Item Guide and description Article Review

publication, study type).

5 Data sources Describe the information sources used (e.g. electronic databases, grey literature databases (digital thesis, policy reports), relevant

organisational websites, experts, information specialists, generic web searches (Google Scholar) hand searching, reference lists) and when the searches conducted; provide the rationale for using the data sources.

All electronic databases were reported and the use of hand searching. Other sources were not used but this was not reported. The rationale for the choice of database was not reported

6 Electronic Search strategy

Describe the literature search (e.g. provide electronic search strategies with population terms, clinical or health topic terms, experiential or social phenomena related terms, filters for qualitative research, and search limits).

A full search strategy was written and the main headings were included in the

publication. A detailed strategy is appended to this thesis.

7 Study screening methods

Describe the process of study screening and sifting (e.g. title, abstract and full text review, number of independent reviewers who screened studies).

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No Item Guide and description Article Review

8 Study characteristics Present the characteristics of the included studies (e.g. year of publication, country, population, number of participants, data collection, methodology, analysis, research questions).

The characteristics of the most relevant studies were included in the main body of the article. All other articles details included were made available on line via the publisher. 9 Study selection results Identify the number of studies screened and

provide reasons for study exclusion (e.g. for comprehensive searching, provide numbers of studies screened and reasons for exclusion indicated in a figure/flowchart; for iterative

searching describe reasons for study exclusion )

A PRISMA chart was used to demonstrate numbers identified and excluded. Reasons for exclusion were reported.

10 Rationale for appraisal Describe the rationale and approach used to appraise the included studies or selected findings (e.g. assessment of conduct (validity and

robustness), assessment of reporting

(transparency), assessment of content and utility of the findings).

Although not reported in the review an appraisal was made of both the content and utility of the findings.

11 Appraisal items State the tools, frameworks and criteria used to appraise the studies or selected findings

No quality assessment tools were used during the review as there was such a limited

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No Item Guide and description Article Review

amount of information. Appraisal has since been undertaken and all but one of the

studies highlighted in the article were of good quality

12 Appraisal process Indicate whether the appraisal was conducted independently by more than one reviewer and if consensus was required.

Two appraisers were involved and there were no major differences in the opinion of the selection or appraisal of the included articles. 13 Appraisal results Present results of the quality assessment and

indicate which articles if any, were

weighted/excluded based on the assessment and give the rationale.

NA

14 Data extraction Indicate which sections of the primary studies were analysed and how were the data extracted from the primary studies?

A data extraction template was used to assess all of the papers. This was included for the six studies reported in the article. For the remainder this was available on line via the publisher

15 Software State the computer software used, if any. NA 16 Number of reviewers Identify who was involved in coding and analysis. NA

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No Item Guide and description Article Review

17 Coding Describe the process for coding of data (e.g. line by line coding to search for concepts).

NA

18 Study comparison Describe how were comparisons made within and across studies (e.g. subsequent studies were coded into pre-existing concepts, and new

concepts were created when deemed necessary).

Comparisons were based on common findings from previous studies.

19 Derivation of themes Explain whether the process of deriving the themes or constructs was inductive or deductive.

Themes were predetermined on the basis of the aims of the search.

20 Quotations Provide quotations from the primary studies to illustrate themes/constructs, and identify whether the quotations were participant quotations of the author’s interpretation.

No

21 Synthesis output Present rich, compelling and useful results that go beyond a summary of the primary studies (e.g. new interpretation, models of evidence,

conceptual models, analytical framework, development of a new theory or construct).

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