Systematic Research Review Critique of Systemic Research

Systematic Research Review

Critique of Systemic Research (SRR) RELATED TO NURSING

Critique of a Systematic Research Review (SRR):

Breast self-examination, breast awareness, and practices of systemic review

Breast cancer is one of the most deadly and fastest-spreading cancers in the world today. To mitigate the tide of this epidemic should ideally include preventative measures as well as proactive treatments. The purpose of the literature review "Breast self-examination, breast awareness, and practices of systemic review" by Parvani (2011) was to assess the current research findings on the degree to which breast self-examination and more general breast self-awareness campaigns were useful in increasing the rates of early detection of breast cancer.

Research rigor of selected studies

Studies were not screened for specific levels of research rigor. General medical databases were searched for relevant studies using Medline, CINAHL, PubMed, Science Direct, and Cochrane using words such as "breast awareness," difference," "breast self-examination," breast cancer screening" and "breast screening" (Parvani 2011: 336). Only articles from the past five years of the authorship of the article (2005-2010) were selected. Date of publication vs. standards of rigor were the determining factors.

Clarity of study presentation and critique

One drawback of this research review is that the studies are not broken down and presented in a clear, segmented format. There is no table outlining the differences between the studies. The emphasis on study selection was clearly more upon quantity rather than individualistic research analysis. The results of the studies are presented in a more general format in terms of their results without extensive pagination being devoted to breaking down their methodology. The upside to this, however, is that the results of all the studies are presented fairly clearly, along with their implications for practice.

Overall finding of the selected studies

The overall finding of the selected studies stressed the relative inadequacy of current screening methods, including mammography and breast self-examination. Of a particular feature of interest was the overall lack of efficacy of breast cancer self-screening. Randomized control trials (RCTs are considered the 'gold standard' of rigor in terms of research analysis) in Russia and Shanghai yielded no apparent medical benefit to breast cancer self-examination. Research indicates that breast self-examination could only detect about 60% of breast cancers detected by mammography as well as some breast cancers not detected by mammography but there is no clinical significance in the size of the tumor and lymph nodes between those who engage in self-examination and those who do not (Parvani 2011: 336-337).

Implications for current practice

The implications for current practice are extensive. Until now, breast cancer self-screening has been touted as extremely useful as a method of cancer prevention, particularly for women who cannot get regular mammography or who are younger than the usual prescribed age for the procedure. However, the literature indicates that self-screening is not particularly useful. Moreover, there are serious concerns that self-screening can actually be actively harmful because it increases the biopsy rate for non-cancerous growths, thus raising the stress level and also the healthcare costs for the patient.

Breast self-awareness was found to have a more positive link to improved health outcomes. But self-awareness is distinct from actual self-screening. This includes being aware of one's risk level and also the appropriate screening methods prescribed for one's age group and genetic profile. "Breast cancer awareness can be defined as a woman becoming familiar with her own breasts and the way that they change throughout her life" (Parvani 2011: 337).

Review conclusions

Unfortunately, in the developing world, breast self-screening is the preferred method of breast cancer screening, due to limited healthcare resources in these nations. This review casts serious doubt both upon the positive 'spin' on self-examination in the developed world has been given as well as the lack of more formal detection procedures in the developing world.