Week #4: Refining Screening Criteria

During Week 4, after completing an initial abstract screening, I wanted to refine the inclusion criteria to better align with my central research question. Through my deeper reading with the literature, it became clear that there is broad consensus regarding the positive relationship between discharge education interventions and patient comprehension. I had originally wanted to address that as one of the products of my research, but now believe it would become redundant to do so. As a result, I focused my research only to determine which specific intervention types were most strongly associated with reductions in hospital readmission. I believe that during my initial abstract screening, I had included too many that would have not given me the necessary information.

Accordingly, studies were excluded if they did not report outcomes related to readmission. Earlier screening stages had been overly liberal, allowing inclusion of studies that described discharge interventions but did not measure readmission in either the abstract or reported results, or alternatively, mentioned the use of multiple interventions at the same time, which could make finding the effect of solely one intervention difficult. The criteria were therefore made more stringent to ensure that all studies would be relevant to my focus.

To further improve the relevance and completeness of the studies, I also did backward citation searching using prior systematic reviews and meta-analyses I had eliminated in a title review (due to my decision not to include these study types) with research aims closely aligned to this project. I looked at reference lists from these reviews to identify additional primary studies that may not have been noted in the initial database searches, with them undergoing the same screening processes.