Voils Corrine I, Barroso Julie, Hasselblad Victor, Sandelowski Margarete
Center for Health Services Research in Primary Care, Veterans Affairs Medical Center and Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
J Adv Nurs. 2007 Jul;59(2):163-77. doi: 10.1111/j.1365-2648.2007.04289.x. Epub 2007 Jun 3.
This paper is a discussion detailing the decisions concerning whether to include or exclude findings from a meta-analysis of report of quantitative studies of antiretroviral adherence in HIV-positive women.
Publication constraints and the absence of reflexivity as a criterion for validity in, and reporting of, quantitative research preclude detailing the many judgements made in the course of a meta-analysis. Yet, such an accounting would assist researchers better to address the unique challenges to meta-analysis presented by the bodies of research they have targeted for review, and to show the subjectivity, albeit disciplined, that characterizes the meta-analytic process.
Data were 29 published and unpublished studies on antiretroviral adherence in HIV-positive women of any race/ethnicity, class, or nationality living in the United States of America. The studies were retrieved between June 2005 and January 2006 using 40 databases.
Findings were included if they met the statistical assumptions of meta-analysis, including: (1) normal distribution of observations; (2) homogeneity of variances; and (3) independence of observations.
Relevant studies and findings were excluded because of issues related to differences in study design, different operationalizations of dependent and independent variables, multiple cuts from common longitudinal data sets, and presentation of unadjusted and adjusted findings. These reasons led to the exclusion of 73% of unadjusted relationships and 87% of adjusted relationships from our data set, leaving few findings to synthesize.
Decisions made during research synthesis studies may result in more information losses than gains, thereby obliging researchers to find ways to preserve findings that are potentially valuable for practice.
本文详细讨论了在对感染艾滋病毒的女性抗逆转录病毒依从性定量研究报告进行荟萃分析时，关于纳入或排除研究结果的决策。
出版限制以及定量研究中缺乏将反思性作为有效性标准及报告内容，使得无法详细说明荟萃分析过程中做出的众多判断。然而，这样的说明将有助于研究人员更好地应对他们所针对审查的研究主体给荟萃分析带来的独特挑战，并展示尽管经过规范但仍具有主观性的荟萃分析过程。
数据来自29项已发表和未发表的关于生活在美国的任何种族/族裔、阶层或国籍的感染艾滋病毒女性抗逆转录病毒依从性的研究。这些研究于2005年6月至2006年1月期间通过40个数据库检索获得。
如果研究结果符合荟萃分析的统计假设，则予以纳入，这些假设包括：（1）观察值呈正态分布；（2）方差齐性；（3）观察值独立。
由于与研究设计差异、因变量和自变量的不同操作化、从共同纵向数据集中多次截取以及未调整和调整后结果的呈现等问题，相关研究和结果被排除。这些原因导致我们的数据集中73%的未调整关系和87%的调整关系被排除，几乎没有结果可供综合。
研究综合过程中做出的决策可能导致信息损失多于收益，从而迫使研究人员寻找方法来保留对实践可能有价值的结果。
