Part 4.
Synthesize: Interpret information and form recommendations for practice.

How do I decide which of multiple studies to use?

(Estimated time: 0.5 hours)

Using your search terms for the scenario, you do a focused search on the top levels of the 6S Pyramid. At the time that this module was developed you would find:

• 0 relevant guidelines
• about 6 potentially relevant systematic reviews (syntheses) that are rated strong or moderate quality
• about 16 potentially relevant individual studies about the effectiveness of interventions to promote bike helmet use among children

However, your question is more focused than merely promoting the use of bike helmets and it quickly becomes apparent that some of these results are not relevant to the scenario.

• Should you read all this information?
• Should you critically appraise it all?
• What is the most efficient way to get through this information?

Figure 4.1 shows how you would decide how to use the varying levels of evidence you have found. Using the 6S Pyramid from Part 2, you would start by retrieving and reading a guideline; and if it was relevant, you would go on to apply the AGREE tool (Part 3) to appraise the guideline. If you and your colleagues concluded that it was a relevant guideline of sufficient quality, and it was published in the past two years, your work may be done. However, if you conclude the guideline is not methodologically strong, you need to go to the next level and look for systematic reviews. For this scenario, a relevant practice guideline does not exist so you can go directly to the systematic review (synthesis) level.

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