Intermittent Fasting for Improving Metabolic Biomarkers: A Systematic ReviewBy:
Rawan Taha
ARIZONA STATE UNIVERSITY
MAY 2023
Chapter 1: Introduction
Metabolic syndrome in general and obesity specifically are increasingly common health
challenges in the general population. Metabolic syndrome includes conditions such as obesity,
hypertension, type 2 diabetes, and dyslipidemia and these are risk factors for cardiovascular
disease, the leading cause of death globally (Aleksandrova et al., 2018). The rates of conditions
identified under the metabolic syndrome are generally high in the population and this presents a
major challenge to public health. People with metabolic syndrome and those at risk can be
identified using metabolic biomarkers, inflammation indicators detected even in people who
have not developed the health condition yet (Aleksandrova et al., 2018). Addressing metabolic
biomarkers in preventative efforts can help reduce the rates of the syndrome and associated
health complications.
The research problem identified is the high rates of obesity and other metabolic conditions in
the United States. As of 2020, 42.4% of Americans were obese (Hales et al., 2020). Additionally,
49.64% had hypertension with many more undiagnosed cases (Chobufo et al., 2020). Type 2
diabetes mellitus rates are on the rise and so are rates of dyslipidemia. These conditions
contributing to the leading cause of death are increasingly common in the United States public
and an urgent solution is needed to address the public health problem. Dietary changes are
universal approaches to reducing metabolic biomarkers and this research revolves around the
question of intermittent fasting.
Reduction of metabolic biomarkers in people at risk of developing metabolic syndrome has
been studied by numerous researchers and several have focused specifically on intermittent
fasting. Kunduraci and Ozbek (2019) evaluated the effect of intermittent fasting among adults in
Turkey. They compared the 16:8 (16 hours of fasting and eight hour window for eating) with
continuous energy restriction programs and found that both approaches were effective in
reducing metabolic biomarkers (Kunduraci & Ozbek, 2019). Similarly, Rynders et al. (2019)
found that people who took intermittent fasting experienced a similar weight loss result as those
who undertook continuous energy restrictions. The main difference was that Rynders et al.
(2019) conducted systematic review of the literature. From these research articles, intermittent
fasting presents the same efficacy as continuous energy restriction diets. The studies also
establish the safety of intermittent fasting.
Elsewhere, Cho et al. (2019) found that people who used intermittent fasting achieved a
higher level of weight loss than those who used regular diets or continuous diet restriction. Their
research was also a systematic review hence collating many research findings from different
studies. Findings from the study by Zouhal et al. (2020) also support these findings. The
researchers found that compared to people who did not practice intermittent fasting during
Ramadhan, those who engaged in intermittent fasting experienced a higher rate of weight loss
and decrease in interleukin and tumor-necrosis factor (Zouhal et al., 2020). These findings
further extend the current research to outline the potential inflammatory pathways for metabolic
biomarkers associated with not only obesity but also cancer. The findings that intermittent
fasting can reduce metabolic biomarkers and contribute to weight loss have also been
corroborated in a Polish study involving older women 65 years and older (Domaszewski et al.,
2020). The researchers compared intermittent fasting 16:8 method with maintenance of previous
feeding habits and concluded that the former was superior in weight loss and reduction of body
fat percentage (Domaszewski et al., 2020). From these studies, it is seen that intermittent fasting
may be superior to usual diets and continuous energy restriction in weight loss and management
of some metabolic biomarkers.
Other studies have focused on intermittent fasting combined with other interventions and 12
hour fasting. Jamshed et al. (2022) evaluated the effectiveness of 12:12 intermittent fasting and
found that it resulted in reduction in weight loss but not body fat. The study was conducted with
obese adults in Birmingham, Alabama. Hottenrott et al. (2020) combined intermittent fasting
with exercise and alkaline supplements. In both intermittent fasting and control group, alkaline
supplements were associated with better performance running. The intermittent fasting group
was more effective in weight reduction (Hottenrott et al., 2020). These findings align with other
research findings on intermittent fasting and obesity.
The current research outlines the importance of intermittent fasting but is still deficient. Most
of the research focuses entirely on body fat and weight as the key biomarkers. Research on other
biomarkers is scarce. Moreover, in most of the research articles reviewed, the studies were either
short-lived or had a small and non-generalizable sample. Some studies were either limited to
women or men which makes them hard to generalize to the public. Also, little research has been
conducted on other metabolic biomarkers such as blood pressure, glucose, and cholesterol.
Therefore, a gap exists in the research on intermittent fasting and its effectiveness in controlling
metabolic biomarkers. Filling this gap presents an opportunity to determine the efficacy of
intermittent fasting in reducing the rates of metabolic syndrome and conditions in the general
public.
Purpose of Study
The purpose of this study will be to determine the effectiveness of intermittent fasting 16:8
method on decreasing metabolic biomarkers in overweight people. The research will determine
whether intermittent fasting can reduce the risk of metabolic syndrome in people who are already
identified as overweight.
Research Aims and Hypotheses
Aim: To determine the effectiveness of intermittent fasting 16:8 method in reducing
metabolic biomarkers in overweight people.
Null Hypothesis: Compared to maintenance of usual dietary habits intermittent fasting is not
associated with significant change in metabolic biomarkers in overweight people.
Alternative Hypothesis: Intermittent fasting reduces metabolic biomarkers in overweight
people.
Definitions
Intermittent fasting: A dietary habit where the individual avoids any food intake for 16
hours per day and has an 8-hour window to eat (Cho et al., 2019).
Metabolic biomarkers: Biological indicators of inflammation that include waist circumference,
blood glucose, blood pressure, triglycerides, and cholesterol levels (Aleksandrova et al., 2018)
Overweight people: People who have a body mass index (BMI) of 25- 29.5 kg/m2
Delimitations and Limitations
The study will be limited to healthy members of the public who have not been diagnosed
with any chronic or terminal illness. It will also be limited to people aged between 18 and 65
years old (adults excluding older adults). The study will be limited to people living in an urban
center in the United States and those who can provide informed consent and be available for
follow-up. The main limitation of the study is that it may not be generalized to other cities or
countries due to the possible unique dietary habits of people in this one city.
References
Aleksandrova, K., Mozaffarian, D., & Pischon, T. (2018). Addressing the perfect storm:
Biomarkers in obesity and pathophysiology of cardiometabolic risk. Clinical
Chemistry, 64(1), 142-153. https://doi.org/10.1373/clinchem.2017.275172
Cho, Y., Hong, N., Kim, K. W., Cho, S. J., Lee, M., Lee, Y. H., & Lee, B. W. (2019). The
effectiveness of intermittent fasting to reduce body mass index and glucose
metabolism: A systematic review and meta-analysis. Journal of Clinical Medicine,
8(10), 1645. https://doi.org/10.3390/jcm8101645.
Chobufo, M. D., Gayam, V., Soluny, J., Rahman, E. U., Enoru, S., Foryoung, J. B., & Nfor,
T. (2020). Prevalence and control rates of hypertension in the USA: 2017–2018.
International Journal of Cardiology Hypertension, 6, 100044.
https://doi.org/10.1016/j.ijchy.2020.100044
Domaszewski, P., Konieczny, M., Pakosz, P., Bączkowicz, D., & Sadowska-Krępa, E.
(2020). Effect of a six-week intermittent fasting intervention program on the
composition of the human body in women over 60 years of age. International Journal
of Environmental Research and Public Health, 17(11), 4138.
https://doi.org/10.3390/ijerph17114138
Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2020). Prevalence of obesity
and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no
360. National Center for Health Statistics, (360).
https://www.cdc.gov/nchs/products/databriefs/db360.htm
Hottenrott, K., Werner, T., Hottenrott, L., Meyer, T. P., & Vormann, J. (2020). Exercise
training, intermittent fasting and alkaline supplementation as an effective strategy for
body weight loss: a 12-week placebo-controlled double-blind intervention with
overweight subjects. Life, 10(5), 74. https://doi.org/10.3390/life10050074.
Jamshed, H., Steger, F. L., Bryan, D. R., Richman, J. S., Warriner, A. H., Hanick, C. J., &
Peterson, C. M. (2022). Effectiveness of early time-restricted eating for weight loss,
fat loss, and cardiometabolic health in adults with obesity: A randomized clinical
trial. JAMA Internal Medicine, 182(9), 953-962.
https://doi.org/10.1001/jamainternmed.2022.3050
Kunduraci, Y. E., & Ozbek, H. (2020). Does the energy restriction intermittent fasting diet
alleviate metabolic syndrome biomarkers? A randomized controlled trial. Nutrients,
12(10), 3213. https://doi.org/10.3390/nu12103213
Rynders, C. A., Thomas, E. A., Zaman, A., Pan, Z., Catenacci, V. A., & Melanson, E. L.
(2019). Effectiveness of intermittent fasting and time-restricted feeding compared to
continuous energy restriction for weight loss. Nutrients, 11(10), 2442.
https://doi.org/10.3390/nu11102442
Zouhal, H., Bagheri, R., Ashtary-Larky, D., Wong, A., Triki, R., Hackney, A. C., &
Abderrahman, A. B. (2020). Effects of Ramadan intermittent fasting on inflammatory
and biochemical biomarkers in males with obesity. Physiology & Behavior, 225,
113090. https://doi.org/10.1016/j.physbeh.2020.113090
Title_____: A Systematic Review
By
Student Name
Applied Project Committee:
Insert Committee names here
ARIZONA STATE UNIVERSITY
August 2021 (date of completion)
CHAPTER I
INTRODUCTION
Insert text here that provides a big-picture overview of your project – shoot for at least 1.5
pages of text per the rubric
Purpose of the Study
Insert text here
Research Aim and Hypothesis
Insert text here
Definitions
Insert text here (and cite all definitions)
Research Limitations
Insert text here
Chapter 1 Rubric (since the scores noted are ranges, please type the score in the appropriate
box).
Meets
Nearly Meets
Does Not Meet
Analysis and
Interpretation
of the Research
Organization of
the research
60.0 to >54.0 pts
It is always clear that this
student understands his/her
research well enough that
he/she can put it into his/her
own words.
54.0 to >41.0 pts
It is usually clear that this
student understands his/her
research well enough that
he/she can mostly put it into
his/her own words.
The research presented
supports the research aim.
The research presented
mostly supports the
research aim.
The first section of the
general introduction (before
the purpose of the study) is
at least 1.5 pages
The first section of the
general introduction (before
the purpose of the study) is
at least 1-1.5 pages
20.0 to >17.0 pts
Research is always clearly
organized with appropriate
headings throughout. Flow of
the research always make
sense and appropriate
transitional phrases are used.
17.0 to >13.0 pts
Research is usually clearly
organized with appropriate
headings throughout. Flow
of the research usually make
sense and some appropriate
transitional phrases are
used.
The introduction includes all
of the required sections
including a general
introduction, purpose of
study, research aim and
hypothesis, definitions and
research limitations.
In-Text
Citations and
Reference Page
10.0 to >8.0 pts
In-text citations are always
provided where appropriate
and are in the correct format
both in-text and on the
reference page.
The introduction includes all
of the required sections
including a general
introduction, purpose of
study, research aim and
hypothesis, definitions and
research limitations.
8.0 to >6.0 pts
In-text citations are usually
provided where appropriate
and are mostly in the
correct format.
41.0 to >0 pts
It is never clear that this
student understands
his/her research well
enough that he/she can
put it into his/her own
words.
The research presented
does not support the
research aim.
The first section of the
general introduction
(before the purpose of
the study) is less than 1
page.
13.0 to >0 pts
Research is not clearly
organized with no
appropriate headings
throughout. Flow of the
research doesn’t make
sense and appropriate
transitional phrases are
not used.
1 or more of the required
sections are missing
(introduction, purpose of
study, research aim and
hypothesis, definitions
and research limitations)
6.0 to >0 pts
In-text citations are rarely
provided where
appropriate and are not
provided at the end of the
paper.
Most definitions are cited.
All definitions are cited.
2 or more of the
definitions are not cited.
Integrity of
Writing
10.0 points
Writing is free of
grammatical, punctuation,
capitalization and spelling
errors.
9.0 to >6.0 pts
Writing contained 1-5
errors.
6.0 to >0 pts
Writing was disorganized
and contained more than
5 errors.
CHAPTER II
EVIDENCE ANALYSIS
A review of the literature on _________ is presented in the following evidence analysis tables. The quality of each study was
assessed along with the type of study, the demographics of the participants, the interventions, and major research findings. In
addition, each table delineates the strengths and limitations of each study. The table was divided into subsections of _______,
______ etc.
Author and
location
Include first
author last name,
location (U.S, Italy
etc) and include a
superscript
citation number.
Insert article
details here –
include at
least 25
articles – these
should be
summarized
Study Design
Participant Details
Method Details
Findings
Randomized Control,
Experimental, CrossSectional, Cohort.
Do not use other
systematic reviews or
meta analyses.
Number, gender, age, other
identifiers
Methods in your own words length of study, exact
intervention details, what were
they looking to measure.
Include all appropriate
outcomes, p-values for
each and if it reached
statistical significance
Strengths and
limitations
Consider population size,
study design, participants,
length of study etc.
succinctly in
your own
words.
Chapter 2 Rubric (since the scores noted are ranges, please type the score in the appropriate box).
The first draft submission needs to include at least 5 studies and follow the basic guidelines of the rubric below that will be used for
the final submission. The first draft starts at 25 points.
Author/location
Meets
Nearly Meets
Does Not Meet
3 points
Each study has an author last name listed and
includes a citation superscript number that
matches with the reference list at the end.
2 points
75% of studies include an author’s last name and
correct citation number.
0-1 point
Studies do not include a citation number.
At least 25 studies were included and cited.
Study Design
7 points
Correctly identified the study design on all
studies included in the table.
At least 25 studies were included on the table.
At least 17-24 studies were included on the
table.
5-6 points
Correctly identified at least 70-99% of the
studies included in the table.
17-24 studies may have been included on the
table.
Less than 17 studies may have been included
on the table.
0-4 points
Correctly identified less than 60% of the studies
included in the table.
Less than 17 studies may have been included
on the table.
Participant
Details
Method Details
Findings
10 points
Provided details on number of study
participants, age, gender, and any other
important details on 100% of the studies
included (disease state, BMI etc)
At least 25 studies were included on the table.
7-9 points
Provided details on number of study
participants, age, gender, and any other
important details on 70-99% of the studies
included (disease state, BMI etc).
0-6 points
Provided details on number of study
participants, age, gender, and any other
important details on less than 60% of the
studies included (disease state, BMI etc).
17-24 studies may have been included on the
table.
Less than 17 studies may have been included
on the table.
20 points
Described the key components of the
methods as well as what the researchers were
studying on 100% of the studies included.
14-19 points
Described the key components of the methods
as well as what the researchers were studying
on 70-99% of the studies included.
0-13 points
Described the key components of the methods
as well as what the researchers were studying
in less than 60% of the studies.
This was succinctly described in the students
own words.
This was mostly succinctly described in the
students own words.
This was not described clearly on the studies or
appeared to be taken directly from the paper
(in which case this would be a score of a 0)
At least 25 studies were included on the table.
At least 17-24 studies were included on the
table.
20 points
Referenced statistical significance and pvalues on all results and everything was in the
students own words on 100% of the studies
included.
At least 25 studies were included on the table.
14-19 points
Referenced statistical significance and p-values
on all results and everything was in the students
own words on 70-99% of the studies included.
17-24 studies may have been included on the
table.
Less than 17 studies were included on the
table.
0-13 points
Referenced statistical significance and p-values
on all results and everything was in the
students own words on less than 60% of the
studies included.
Less than 17 studies may have been included
on the table.
Strengths and
Limitations
10 points
Strengths and limitations are clearly labeled
on 100% of the studies included and it’s clear
that the student understands what makes a
strong study design and how it relates to the
original research question.
7-9 points
Strengths and limitations are clearly labeled on
70-99% of the studies included and it’s mostly
clear that the student understands what makes
a strong study design and how it relates to the
original research question.
0-6 points
Strengths and limitations are clearly labeled on
60% of the studies included and it’s not always
clear that the student understands what makes
a strong study design and how it relates to the
original research question.
At least 25 studies were included on the table.
17-24 studies may have been included on the
table.
Less than 17 studies may have been included
on the table.
Search Terms
used for
Systematic
Review Table
(should now be
complete in the
Methods
chapter)
20 points
At least 3 databases were used for the search
14-19 points
At least 2 databases were used for the search
0-13 points
At least 1-2 databases were used for the search
For 100% of the lines on the table:
· Search strings are clearly listed and make
sense with the topic
· Filters are clearly listed and are specific
It is clear that the student completed an
excellent search of the literature with >20
different searches.
For 70-99% of the lines on the table:
· Search strings are clearly listed and make
sense with the topic
· Filters are clearly listed and are specific
It is clear that the student completed a good
search of the literature with multiple searches
with 15-19 different searches.
For less than 60% of the lines on the table:
· Search strings are clearly listed and make
sense with the topic
· Filters are clearly listed and are specific
The student completed a less thorough search
of the literature with less than 15 different
searches.
PRISMA Flow
Diagram (should
now be
complete in the
Methods
chapter)
10 points
Diagram is filled in with all “n”’s and makes
sense against the number of records kept
from the Search Term table.
7-9 points
70-99% of the diagram is filled in and the “n”
values mostly make sense against the number of
records kept from the Search Term table.
0-6 points
Less than 60% of the diagram is filled in and the
“n” values may not make sense against the
number of records kept from the Search Term
table.
CHAPTER III
METHODS
Insert text here describing the following from the PRISMA checklist – describe in paragraph
form but touch on each item below (then delete the table):
METHODS
Protocol and
registration
Indicate if a review protocol exists, if and where it can be accessed
(e.g., Web address), and, if available, provide registration information
including registration number.
Eligibility criteria
Specify study characteristics (e.g., PICOS, length of follow-up) and
report characteristics (e.g., years considered, language, publication
status) used as criteria for eligibility, giving rationale.
Information
sources
Describe all information sources (e.g., databases with dates of
coverage, contact with study authors to identify additional studies) in the
search and date last searched.
Search
Present full electronic search strategy for at least one database,
including any limits used, such that it could be repeated.
Study selection
State the process for selecting studies (i.e., screening, eligibility,
included in systematic review, and, if applicable, included in the metaanalysis).
Data collection
process
Describe method of data extraction from reports (e.g., piloted forms,
independently, in duplicate) and any processes for obtaining and
confirming data from investigators.
Data items
List and define all variables for which data were sought (e.g., PICOS,
funding sources) and any assumptions and simplifications made.
Risk of bias in
individual
studies
Describe methods used for assessing risk of bias of individual studies
(including specification of whether this was done at the study or
outcome level), and how this information is to be used in any data
synthesis.
Summary
measures
State the principal summary measures (e.g., risk ratio, difference in
means).
Synthesis of
results
Describe the methods of handling data and combining results of
studies, if done, including measures of consistency (e.g., I2) for each
meta-analysis.
After all the text, include the following tables:
PICO Inclusion Criteria (for each letter below, include all possible search terms for each)
Population
Insert text here
Intervention
Insert text here
Comparison
Insert text here
Outcome
Insert text here
Search Terms Used for Systematic Review and Evidence Analysis (this can be started during
your methods submission, then completed as you finish chapter 2)
Database
Insert text
here –
this will
be many
rows to
track all
of the
searches
Date of
search
Search String
Filters
Used
Number
of
results
Number of
results
after
removing
duplicates
After
reviewing
for
quality,
articles
kept
PRISMA 2009 Flow Diagram (this should be completed by the time you
finish Chapter 2)
Click on this link, go to File, Make a copy, copy the chart, then double click on
each box and fill in your number of articles for each box.
Insert the filled out chart here.
Chapter 3 Rubric (since the scores noted are ranges, please type the score in the appropriate
box).
Methods
paragraph
description
Meets
Nearly Meets
Does Not Meet
50 points
Discusses the key points of:
· How PRISMA was used
· How PICO was used
· Filters used (i.e.
published year, language,
no reviews, human
research etc)
· Databases used
· Key search terms
· How the Academy of
Nutrition and Dietetics
Quality Criteria Checklist
was used
Paragraph description is at
least 1.5 pages.
35-49 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-34 points
Includes less than 70% of
the items listed in the
“meets” category.
Paragraph description is 1
page.
Paragraph description is
less than 1 page.
Integrity of
Writing of
Methods
paragraph
10 points
Writing is free of
grammatical, punctuation,
capitalization and spelling
errors.
7-9 points
Writing contained 1-5 errors.
0-6 points
Writing was disorganized
and contained more than
5 errors.
PICO Inclusion
Criteria Table
14-15 points
10-13 points
0-9 points
Table is complete with each
letter of PICO completed.
Most search terms are
expanded upon.
Table is not complete with
1 or more letters not
identified.
25 points
The table has been started
for the first submission and
completed for the second
submission.
with evidence of at least 3
databases used for the
search.
17-24 points
At least 2 databases were
used for the search
0-16 points
At least 1-2 databases
were used for the search
For 70-99% of the lines on
the table:
· Search strings are clearly
listed and make sense with
the topic
· Filters are clearly listed
and are specific
It is clear that the student
completed a good search of
the literature with multiple
searches with 7-9 different
searches (the goal is 20 when
this is rechecked)
For less than 60% of the
lines on the table:
· Search strings are
clearly listed and make
sense with the topic
· Filters are clearly listed
and are specific
The student completed a
less thorough search of
the literature with less
than 6 different searches
(the goal is 20 when this is
rechecked)
Search Terms
used for
Systematic
Review Table
For 100% of the lines on the
table:
· Search strings are clearly
listed and make sense with
the topic
· Filters are clearly listed
and are specific
It is clear that the student
completed an excellent
search of the literature
with >10 different searches
(the goal will be a total of
20 when this is rechecked).
PRISMA Flow
Diagram (will
be checked at
the conclusion
of submitting
chapter 2 but
will reside in
Chapter 3)
0 points
This will be checked at the
conclusion of chapter 2 so
take a look at it The goal is to have the
diagram filled in with all
“n”’s and makes sense
against the number of
records kept from the
Search Term table.
CHAPTER IV
RESULTS
Review your evidence analysis table from chapter 2 comparing and contrasting the types of
studies found, length of study, number of participants and methodological differences.
From the PRISMA checklist:
RESULTS
Study selection
Give numbers of studies screened, assessed for eligibility, and included
in the review, with reasons for exclusions at each stage, ideally with a
flow diagram.
Study
characteristics
For each study, present characteristics for which data were extracted
(e.g., study size, PICOS, follow-up period) and provide the citations.
Risk of bias
within studies
Present data on risk of bias of each study and, if available, any outcome
level assessment (see item 12).
Results of
individual studies
For all outcomes considered (benefits or harms), present, for each study:
(a) simple summary data for each intervention group (b) effect estimates
and confidence intervals, ideally with a forest plot.
Synthesis of
results
Present results of each meta-analysis done, including confidence
intervals and measures of consistency.
Risk of bias
across studies
Present results of any assessment of risk of bias across studies (see
Item 15).
Additional
analysis
Give results of additional analyses, if done (e.g., sensitivity or subgroup
analyses, meta-regression [see Item 16]).
Chapter 4 Rubric to be completed by the peer reviewer (first 2 sections only), mentor, and
instructor (since the scores noted are ranges, please type the score in the appropriate box).
Results
description
Meets
Nearly Meets
Does Not Meet
30 points
Discussed the key points of:
·
Presentation of
PRISMA flow diagram
results
·
Breakdown of study
types used in analysis
·
Organized by subtypes using sub-headings
·
Synthesis of results
from studies presented
21-29 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-20 points
Includes less than 70% of
the items listed in the
“meets” category.
Paragraph description is 1
page.
Paragraph description is
less than 1 page.
Paragraph description is at
least 1.5 pages.
Integrity of
Writing of
Results
10 points
Writing is free of
grammatical, punctuation,
capitalization and spelling
errors.
7-9 points
Writing contained 1-5 errors.
0-6 points
Writing was disorganized
and contained more than
5 errors.
Peer Review
10 points
Provided at least 3 items of
positive feedback
7-9 points
Provided 2 items of positive
feedback
0-6 points
Did not provide positive
feedback
Provided at least 3 items of
corrective feedback
Provided 2 items of
corrective feedback
Did not provide corrective
feedback
Provided corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided few corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Did not provide
corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided a summary
paragraph to the author of
how to improve writing flow
and content
Provided a sentence to the
author of how to improve
writing flow and content; or
the paragraph did not
suggest improvements
Did not provide a
summary paragraph to the
author of how to improve
writing flow and content
CHAPTER V
DISCUSSION
Compare and contrast the results of each study and get deeper into the differences between
studies and why results may have differed. Ultimately, come to an answer to your research
question based on all the research you reviewed.
From the PRISMA checklist:
DISCUSSION
Summary of
evidence
Summarize the main findings including the strength of evidence for each
main outcome; consider their relevance to key groups (e.g., healthcare
providers, users, and policy makers).
Limitations
Discuss limitations at study and outcome level (e.g., risk of bias), and at
review-level (e.g., incomplete retrieval of identified research, reporting bias).
CHAPTER VI
CONCLUSION
Insert text here discussing the following from the PRISMA checklist:
Conclusions
Provide a general interpretation of the results in the context of other
evidence, and implications for future research.
Chapters 5&6 Rubric to be completed by the peer reviewer (first 2 sections only), mentor, and
instructor (since the scores noted are ranges, please type the score in the appropriate box).
Discussion of
Results
Meets
Nearly Meets
Does Not Meet
20 points
Discussed the overall
findings of the review
results
11-19 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-10 points
Includes less than 70% of
the items listed in the
“meets” category.
Compared results to other
studies or reviews
Paragraph description is 2
page.
Paragraph description is
less than 1 page.
7-9 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-6 points
Includes less than 70% of
the items listed in the
“meets” category.
Paragraph description is 0.25
page.
Paragraph description is 12 sentences.
Identified strengths and
weaknesses of research
reviewed
Identified strengths and
weaknesses of the review
Paragraph description is at
least 3 pages.
Conclusions
10 points
Discussed the major
findings of the review
Discussed the utility of the
results of the review in
practice or future research
Paragraph description is at
least 0.5 page.
Integrity of
Writing of
Results
10 points
Writing is free of
grammatical, punctuation,
capitalization and spelling
errors.
7-9 points
Writing contained 1-5 errors.
0-6 points
Writing was disorganized
and contained more than
5 errors.
Peer Review
10 points
Provided at least 3 items of
positive feedback
7-9 points
Provided 2 items of positive
feedback
0-6 points
Did not provide positive
feedback
Provided at least 3 items of
corrective feedback
Provided 2 items of
corrective feedback
Did not provide corrective
feedback
Provided corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided few corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided a summary
paragraph to the author of
how to improve writing flow
and content
Provided a sentence to the
author of how to improve
writing flow and content; or
the paragraph did not
suggest improvements
Did not provide
corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Did not provide a
summary paragraph to the
author of how to improve
writing flow and content
References
Insert references here
Example of AMA style:
Florez HR, Martinez RL. Outdoor exercise reduces the risk of hypovitaminosis D in the
obese. J Steroid Biochem Mol Bio. 2007;103(3-5):679-681. doi:10.1016
/j.jsbmb.2006.12.032.
Review AMA style here: http://library.stkate.edu/assets/library-uploads/files/citeAMA.pdf
CHAPTER III
METHODS
Insert text here describing the following from the PRISMA checklist – describe in paragraph
form but touch on each item below (then delete the table):
METHODS
Protocol and
registration
Indicate if a review protocol exists, if and where it can be accessed
(e.g., Web address), and, if available, provide registration information
including registration number.
Eligibility criteria
Specify study characteristics (e.g., PICOS, length of follow-up) and
report characteristics (e.g., years considered, language, publication
status) used as criteria for eligibility, giving rationale.
Information
sources
Describe all information sources (e.g., databases with dates of
coverage, contact with study authors to identify additional studies) in the
search and date last searched.
Search
Present full electronic search strategy for at least one database,
including any limits used, such that it could be repeated.
Study selection
State the process for selecting studies (i.e., screening, eligibility,
included in systematic review, and, if applicable, included in the metaanalysis).
Data collection
process
Describe method of data extraction from reports (e.g., piloted forms,
independently, in duplicate) and any processes for obtaining and
confirming data from investigators.
Data items
List and define all variables for which data were sought (e.g., PICOS,
funding sources) and any assumptions and simplifications made.
Risk of bias in
individual
studies
Describe methods used for assessing risk of bias of individual studies
(including specification of whether this was done at the study or
outcome level), and how this information is to be used in any data
synthesis.
Summary
measures
State the principal summary measures (e.g., risk ratio, difference in
means).
Synthesis of
results
Describe the methods of handling data and combining results of
studies, if done, including measures of consistency (e.g., I2) for each
meta-analysis.
After all the text, include the following tables:
PICO Inclusion Criteria (for each letter below, include all possible search terms for each)
Population
Insert text here
Intervention
Insert text here
Comparison
Insert text here
Outcome
Insert text here
Search Terms Used for Systematic Review and Evidence Analysis (this can be started during
your methods submission, then completed as you finish chapter 2)
Database
Insert text
here –
this will
be many
rows to
track all
of the
searches
Date of
search
Search String
Filters
Used
Number
of
results
Number of
results
after
removing
duplicates
After
reviewing
for
quality,
articles
kept
PRISMA 2009 Flow Diagram (this should be completed by the time you
finish Chapter 2)
Click on this link, go to File, Make a copy, copy the chart, then double click on
each box and fill in your number of articles for each box.
Insert the filled out chart here.
Chapter 3 Rubric to be completed by the mentor and instructor (since the scores noted are
ranges, please type the score in the appropriate box).
Methods
paragraph
description
Meets
Nearly Meets
Does Not Meet
50 points
Discusses the key points of:
· How PRISMA was used
· How PICO was used
· Filters used (i.e.
published year, language,
no reviews, human
research etc)
· Databases used
· Key search terms
· How the Academy of
Nutrition and Dietetics
Quality Criteria Checklist
was used
Paragraph description is at
least 1.5 pages.
35-49 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-34 points
Includes less than 70% of
the items listed in the
“meets” category.
Paragraph description is 1
page.
Paragraph description is
less than 1 page.
Integrity of
Writing of
Methods
paragraph
10 points
Writing is free of
grammatical, punctuation,
capitalization and spelling
errors.
7-9 points
Writing contained 1-5 errors.
0-6 points
Writing was disorganized
and contained more than
5 errors.
PICO Inclusion
Criteria Table
14-15 points
10-13 points
0-9 points
Table is complete with each
letter of PICO completed.
Most search terms are
expanded upon.
Table is not complete with
1 or more letters not
identified.
25 points
The table has been started
with evidence of at least 3
databases used for the
search.
17-24 points
At least 2 databases were
used for the search
0-16 points
At least 1-2 databases
were used for the search
For 70-99% of the lines on
the table:
· Search strings are clearly
listed and make sense with
the topic
· Filters are clearly listed
and are specific
It is clear that the student
completed a good search of
the literature with multiple
searches with 7-9 different
searches (the goal is 20 when
this is rechecked)
For less than 60% of the
lines on the table:
· Search strings are
clearly listed and make
sense with the topic
· Filters are clearly listed
and are specific
The student completed a
less thorough search of
the literature with less
than 6 different searches
(the goal is 20 when this is
rechecked)
Search Terms
used for
Systematic
Review Table
For 100% of the lines on the
table:
· Search strings are clearly
listed and make sense with
the topic
· Filters are clearly listed
and are specific
It is clear that the student
completed an excellent
search of the literature
with >10 different searches
(the goal will be a total of
20 when this is rechecked).
PRISMA Flow
Diagram (will
be checked at
the conclusion
of submitting
chapter 2 but
will reside in
Chapter 3)
0 points
This will be checked at the
conclusion of chapter 2 so
take a look at it The goal is to have the
diagram filled in with all
“n”’s and makes sense
against the number of
records kept from the
Search Term table.
CHAPTER IV
RESULTS
Review your evidence analysis table from chapter 2 comparing and contrasting the types of
studies found, length of study, number of participants and methodological differences.
From the PRISMA checklist:
RESULTS
Study selection
Give numbers of studies screened, assessed for eligibility, and included
in the review, with reasons for exclusions at each stage, ideally with a
flow diagram.
Study
characteristics
For each study, present characteristics for which data were extracted
(e.g., study size, PICOS, follow-up period) and provide the citations.
Risk of bias
within studies
Present data on risk of bias of each study and, if available, any outcome
level assessment (see item 12).
Results of
individual studies
For all outcomes considered (benefits or harms), present, for each study:
(a) simple summary data for each intervention group (b) effect estimates
and confidence intervals, ideally with a forest plot.
Synthesis of
results
Present results of each meta-analysis done, including confidence
intervals and measures of consistency.
Risk of bias
across studies
Present results of any assessment of risk of bias across studies (see
Item 15).
Additional
analysis
Give results of additional analyses, if done (e.g., sensitivity or subgroup
analyses, meta-regression [see Item 16]).
Chapter 4 Rubric to be completed by the peer reviewer (first 2 sections only), mentor, and
instructor (since the scores noted are ranges, please type the score in the appropriate box).
Results
description
Meets
Nearly Meets
Does Not Meet
30 points
Discussed the key points of:
·
Presentation of
PRISMA flow diagram
results
·
Breakdown of study
types used in analysis
·
Organized by subtypes using sub-headings
·
Synthesis of results
from studies presented
21-29 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-20 points
Includes less than 70% of
the items listed in the
“meets” category.
Paragraph description is 1
page.
Paragraph description is
less than 1 page.
Paragraph description is at
least 1.5 pages.
Integrity of
Writing of
Results
10 points
Writing is free of
grammatical, punctuation,
capitalization and spelling
errors.
7-9 points
Writing contained 1-5 errors.
0-6 points
Writing was disorganized
and contained more than
5 errors.
Peer Review
10 points
Provided at least 3 items of
positive feedback
7-9 points
Provided 2 items of positive
feedback
0-6 points
Did not provide positive
feedback
Provided at least 3 items of
corrective feedback
Provided 2 items of
corrective feedback
Did not provide corrective
feedback
Provided corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided few corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided a summary
paragraph to the author of
how to improve writing flow
and content
Provided a sentence to the
author of how to improve
writing flow and content; or
the paragraph did not
suggest improvements
Did not provide
corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Did not provide a
summary paragraph to the
author of how to improve
writing flow and content
CHAPTER V
DISCUSSION
Compare and contrast the results of each study and get deeper into the differences between
studies and why results may have differed. Ultimately, come to an answer to your research
question based on all the research you reviewed.
From the PRISMA checklist:
DISCUSSION
Summary of
evidence
Summarize the main findings including the strength of evidence for each
main outcome; consider their relevance to key groups (e.g., healthcare
providers, users, and policy makers).
Limitations
Discuss limitations at study and outcome level (e.g., risk of bias), and at
review-level (e.g., incomplete retrieval of identified research, reporting bias).
CHAPTER VI
CONCLUSION
Insert text here discussing the following from the PRISMA checklist:
Conclusions
Provide a general interpretation of the results in the context of other
evidence, and implications for future research.
Chapters 5&6 Rubric to be completed by the peer reviewer (first 2 sections only), mentor, and
instructor (since the scores noted are ranges, please type the score in the appropriate box).
Discussion of
Results
Meets
Nearly Meets
Does Not Meet
20 points
Discussed the overall
findings of the review
results
11-19 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-10 points
Includes less than 70% of
the items listed in the
“meets” category.
Compared results to other
studies or reviews
Paragraph description is 2
page.
Paragraph description is
less than 1 page.
7-9 points
Includes at least 70-99% of
the topics in the “meets”
category.
0-6 points
Includes less than 70% of
the items listed in the
“meets” category.
Paragraph description is 0.25
page.
Paragraph description is 12 sentences.
7-9 points
Writing contained 1-5 errors.
0-6 points
Writing was disorganized
and contained more than
5 errors.
Identified strengths and
weaknesses of research
reviewed
Identified strengths and
weaknesses of the review
Paragraph description is at
least 3 pages.
Conclusions
10 points
Discussed the major
findings of the review
Discussed the utility of the
results of the review in
practice or future research
Paragraph description is at
least 0.5 page.
Integrity of
Writing of
Results
10 points
Writing is free of
grammatical, punctuation,
capitalization and spelling
errors.
Peer Review
10 points
Provided at least 3 items of
positive feedback
7-9 points
Provided 2 items of positive
feedback
0-6 points
Did not provide positive
feedback
Provided at least 3 items of
corrective feedback
Provided 2 items of
corrective feedback
Did not provide corrective
feedback
Provided corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided few corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Did not provide
corrections on
grammatical and spelling
errors (or noted that there
weren’t any)
Provided a summary
paragraph to the author of
how to improve writing flow
and content
Provided a sentence to the
author of how to improve
writing flow and content; or
the paragraph did not
suggest improvements
Did not provide a
summary paragraph to the
author of how to improve
writing flow and content
References
Insert references here
Example of AMA style:
Florez HR, Martinez RL. Outdoor exercise reduces the risk of hypovitaminosis D in the
obese. J Steroid Biochem Mol Bio. 2007;103(3-5):679-681. doi:10.1016
/j.jsbmb.2006.12.032.
Review AMA style here: http://library.stkate.edu/assets/library-uploads/files/citeAMA.pdf
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