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1. Which statement about systematic reviews is true?
A) “Systematic review” is just another name for a literature review.
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B) Systematic reviews follow similar “rules” as for primary studies.
C) All systematic reviews of quantitative studies are meta-analyses.
D) All systematic reviews of quantitative studies are metasyntheses.
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2. Systematic reviews are the cornerstone of:
A) evidence-based practice.
B) evidence hierarchies. abirb.com/test
C) meta-analyses.
D) primary studies.
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3. Which is the unit of analysis in a meta-analysis?
A) Individual study participants
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B) A primary qualitative study
C) A primary quantitative study
D) Prior systematic reviews
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4. Which is an advantage of meta-analysis, compared to narrative systematic reviews?
A) It is less work than a narrative systematic review.
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B) It is feasible with a wider range of research questions than a narrative systematic
review.
C) It integrates information in a more objective manner than a narrative systematic
review. abirb.com/test
D) It requires a smaller sample of primary studies than a narrative systematic review.

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5. Meta-analysts should avoid the “apples and oranges” problem. What does this mean?
A) Meta-analyses should focus primarily on topics relating to nutrition and health
promotion.
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B) The same instruments—not different ones—should be used to measure outcomes in
all the studies in the review.
C) The meta-analysts should be the same researchers as those who did the primary
studies.
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D) All of the studies in the review should focus on the same research question.

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6. Which is a criterion for undertaking a meta-analysis?
A) All of the primary studies must have statistically significant results.
B) All of the primary studies must have clinically significant results.
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C) The results among the primary studies in a meta-analysis must all be consistent.
D) There needs to be a sufficiently large number of relevant primary studies.

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7. Under which condition would a meta-analysis not be appropriate?
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A) Results among studies are highly conflicting.
B) Research questions across studies are nearly identical.
C) There is a large pool of primarily studies.
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D) The independent variable is consistent across studies.

8. Which research question is appropriately phrased for a meta-analysis, within the PICO
framework? abirb.com/test
A) “What is the effect of music on agitation levels in patients with dementia?”
B) “What is the experience of caring for a patient with dementia?”
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C) “What factors put people at risk for dementia?”
D) “What percentage of adults aged 60 years and older have dementia?”

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9. As a strategy for refining a research question for a systematic review, researchers may
undertake:
A) an effect size analysis.
B) a scoping review. abirb.com/test
C) a mixed study review.
D) a power analysis.
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10. Researchers must assess primary studies for eligibility in a meta-analysis. Which is a
plausible inclusion criterion?
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A) The primary studies must have had funding.
B) The primary study reports must be written in English.
C) The primary studies must have been based on pilot studies.
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D) The primary studies must be within the grounded theory tradition.

11. Which statement about the design of a meta-analytic study is true?

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A) Statistical heterogeneity of results across primary studies is rare.
B) Only published research reports are included in meta-analyses.
C) Low-quality studies are excluded from meta-analyses.
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D) If statistical heterogeneity is anticipated, subgroup analyses to explore variation in
effects are often planned.

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12. There is no consensus on whether systematic reviews should include the grey literature.
What is the grey literature?
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A) Articles published in non–peer-reviewed journals
B) Articles published in peer-reviewed journals
C) Unpublished reports
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D) Earlier literature reviews

13. What is at risk when the grey literature is excluded from a meta-analysis?
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A) The risk is that studies with nonsignificant results will be underrepresented.
B) The risk is that studies not published in English will be underrepresented.
C) The risk is that studies with weak effects will be overrepresented.
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D) The risk is that studies with biases will be overrepresented.

14. Which statement about evaluating primary study quality is true?

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A) The best way to quantify primary study quality is to grade studies on a scale from 0
to 10.
B) The Cochrane Handbook recommends coding primary studies for the
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presence/absence of key methodologic features.
C) Researchers who are experts do not need to do an interrater reliability assessment
for evaluations of primary study quality.
D) If two raters disagree in their evaluations of study quality, the best way to resolve
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the difference is to flip a coin (i.e., randomly select one reviewer's rating).

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15. Which piece of information is not typically encoded for each primary study in a
meta-analysis?
A) Participant characteristics (e.g., mean age)
B) Sample size
C) Effect sizes abirb.com/test
D) Number of coders

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16. Which cannot be used as an effect size index for a meta-analysis?
A) Standardized mean difference or d
B) Intensity effect size
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C) Pearson's correlation coefficient (r)
D) The odds ratio (OR)

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17. A meta-analyst sought to estimate the effect of interventions designed to improve
mental health outcomes for family members with a relative in palliative care. The
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primary studies compared participants in an intervention group with those in a control
group on an interval-level scale that measured depressive symptoms. Which effect size
index would be used?
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A) Cohen's d (standardized mean difference)
B) The relative risk (RR) index
C) Pearson's r
D) The odds ratio (OR)
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18. A meta-analyst addressed the question of whether mindfulness-based interventions were
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effective in reducing anxiety in patients with cancer and found high levels of statistical
heterogeneity (i.e., significant variation of effects across studies). What should the
meta-analyst do?
A) Abandon efforts to undertake a meta-analysis
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B) Use a fixed effects analytic model
C) Use a random effects analytic model
D) Ignore the heterogeneity
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19. Which is a visual method of identifying heterogeneity among primary studies in a
meta-analysis?
A) A scatterplot abirb.com/test
B) A histogram
C) A forest plot
D) A frequency distribution abirb.com/test

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20. For each primary study in a meta-analysis, a forest plot portrays information about:
A) 95% CIs around an effect size.
B) number of study participants.
C) quality assessment scores.
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D) sample size and standard errors.

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21. Which is a viable approach to dealing with primary study quality in a meta-analysis?
A) Disregarding quality in analyses but reporting mean quality ratings in the report
B) Doing sensitivity analyses to see if effects change when low-quality studies are
excluded
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C) Using a random effects model rather than a fixed effects model
D) Using a forest plot to plot study quality against the effect size index

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22. Which best characterizes metasyntheses?
A) They rely primarily on phenomenological primary studies.
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B) They are narrative summaries of research findings.
C) They are similar to concept analyses.
D) They involve interpretation as well as integration of previous findings.
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23. What issue has been controversial among metasynthesists?
A) Whether or not to integrate studies from different qualitative research traditions
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B) Whether or not to integrate some quantitative findings into the analysis
C) Whether or not to omit studies published before 2000
D) Whether or not to use a random effects or fixed effects model
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24. Which activity is not normally undertaken as part of doing a metasynthesis?
A) Systematically extracting and recording data from the primary studies
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B) Searching for and selecting a sample of primary studies
C) Obtaining the original data set from primary study researchers
D) Evaluating the quality of the primary studies
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25. Which is true about researchers conducting metasyntheses?
A) They use only primary studies from peer-reviewed journals in the analysis.
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B) They perform little advance planning, as it is not needed in qualitative research.
C) They sample primary studies until saturation is achieved.
D) They often conduct original studies on the same topic as the metasynthesis they are
conducting. abirb.com/test

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26. One approach to systematically integrating qualitative findings is called
meta-ethnography. Which scholars are associated with this approach?
A) Sandelowski and Barroso
B) Glaser and Strauss
C) Thorne and Morse abirb.com/test
D) Noblit and Hare

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27. In the Noblit and Hare approach to integrating qualitative findings, one phase involves:
A) computing an intensity effect size.
B) computing a frequency effect size.
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C) doing a reciprocal translation analysis.
D) undertaking a meta-summary.

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28. One approach to systematically integrating qualitative findings distinguished qualitative
reports that are “summaries” and ones that are “syntheses”; the researchers argued for
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including only “syntheses” as the primary studies in a metasynthesis. Which scholars
are associated with this approach?
A) Sandelowski and Barroso
B) Glaser and Strauss abirb.com/test
C) Thorne and Morse
D) Noblit and Hare
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29. A metasynthesist calculated manifest effect sizes in a meta-summary of qualitative
studies on adolescent mothers' experience of being homeless. The researcher divided the
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number of unduplicated reports that contained the theme of “enduring abuse” by all
unduplicated reports in the analysis. What type of effect size is this?
A) Intensity effect size
B) Frequency effect size
C) Reciprocal effect size abirb.com/test
D) Refutational effect size

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30. Which is the unit of analysis in computing a manifest effect size, using the
Sandelowski-Barroso approach to integrating qualitative studies?
A) An individual primary study
B) A study participant abirb.com/test
C) A study summary
D) A qualitative finding or theme
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Answer Key

1. B abirb.com/test
2. A
3. C
4. C abirb.com/test
5. D
6. D
7.
8.
A
A
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9. B
10. B
11. D abirb.com/test
12. C
13. A
14.
15.
B
D
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16. B
17. A
18. C abirb.com/test
19. C
20. A
21.
22.
B
D
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23. A
24. C
25. D abirb.com/test
26. D
27. C
28.
29.
A
B
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30. D

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