A process model for evidence-based literature syntheses

To describe the development and implementation of the Triad Model of Research Synthesis, developed as a mechanism to produce systematic literature reviews that can serve as sources of evidence for decision making in health care.

Authors' recollections of the development and implementation process over a one-year period during 2002. Tracking forms were completed by members of three triad teams as they compiled research syntheses on clinical topics: pharmacologic treatment of dyspnea, assessment of sleep disturbances in patients with cancer, and exercise as an intervention for cancer-related fatigue.

The systematic literature review process includes the following steps: (a) organize, search the literature, and focus the research synthesis question; (b) critique the selected literature; (c) synthesize the evidence; and (d) write. On average, triad members spent hours that were equivalent to full-time work during the year (excluding completion of manuscripts) on the synthesis projects. Hours spent varied by member role and with each phase of the process.

Performing a research synthesis using the triad model was a productive and resource-intensive experience that points to the need for negotiating resources prior to embarking on such an exercise.

Given a group of highly motivated nurses and others with adequate time and resources, this model can be effective when developing systematic reviews about a variety of topics. Literature syntheses developed can be used as evidence for clinicians and others to develop practice protocols and other evidence-based care guidelines.