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DEPARTMENTS: Guest Editorial

The Evidence Synthesis Imperative

Elswick, R.K. Jr PhD; Kagan, Sarah H. PhD, RN; Melendez-Torres, G.J. DPhil, RN

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doi: 10.1097/NCC.0000000000000807
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Synthesis of evidence is the imperative of our scientific era. Many cancer nurse scientists conducting investigations today came of age in a far different scientific epoch. Not long ago, the science relevant to cancer diagnosis, treatment, and the human experience of them along with life beyond cancer depended almost wholly on original findings and the promise of replication. Now—in an age overflowing with information and, indeed, disinformation witness Retraction Watch and similar alerts—those who depend on the science conducted by cancer nurse scientists and their colleagues from other disciplines require our synthesis of extant evidence.

Arguably, such emphasis on evidence synthesis likely surprises or even concerns many among us. Scientific dialogue abounds with language of innovation so that original, novel, and other synonyms and near synonyms feel ubiquitous in contemporary research initiatives. Nonetheless, observation of current cancer care suggests lags in adopting as well as outright neglect of current evidence are commonplace. Reasons behind delays and omissions are many. Whatever the cause, gaps in implementation risk safety and threaten quality processes, experiences, and outcomes.

Similarly, news and other media lead a trend toward making more of findings from a single study than scientifically possible. In our media conscious times, all scientists are frequently delighted with media coverage highlighting their original contributions. However, public interest tends to mandate a “what this means for you” focus in media coverage. At best, unsophisticated analyses, premature conclusions, and overstated implications result. Those results sit at the intersection of scientific emphasis on original findings and global excitement about media coverage.

The scientific community, both that represented here as readers of Cancer Nursing and the international scientific community writ large, offers sound and responsible efforts to mitigate risk and threats present in the science-media intersection. From “bench to bedside,” to knowledge transfer, and on to implementation science, scientists conscious of ethical and moral accountability are leading the development of scientific methodologies and commensurate means of assessment, application, and evaluation.

Safe, responsible, and truly innovative scientific advancement mandates rigorous and robust synthesis of available evidence. Transfer and implementation depend upon synthesis, as do proposals for new studies aiming to generate novel evidence. Yet evidence synthesis methods are frequently less well specified. Similarly, they are often incompletely taught to scientists and their colleagues outside nursing.

Skill and quality in application of current and development of new evidence synthesis methods vary across societies and institutions around the globe. Highlighting strong methods and noteworthy results in evidence synthesis projects affords advantages of instruction in these methods. Instruction by example lies in parallel to the more expected substantive guidance regarding decisions about application in practice and next steps in further synthesis.

As an editorial team educated in different scientific eras and possessed of highly varied skills, we are privileged to deliver to you—our readers and colleagues around the world—this special issue of Cancer Nursing. It is focused wholly on evidence synthesis to showcase high-quality projects and to offer examples of meritorious application of the relevant methodologies. Although the journal has published evidence synthesis reports in the past, this issue is distinctive in its exclusive focus in this domain. The articles included resulted from an international call that garnered a remarkable number of submissions and on an exceptionally collaborative editorial and peer review process.

Our editorial team includes an oncology nurse (SHK), a biostatistician (RKE), and a nurse scientist specializing in evidence synthesis methods (GJMT). We worked closely with one another to ensure critical and supportive engagement with authors who submitted their work and to uphold the aim of the issue itself within the scope and aims of the journal. We also invited Professor Jane Noyes from Bangor University in Wales, a nurse working in health services research and widely acknowledged for her leadership in evidence synthesis methods, to offer a commentary on the topic and the special issue as a way of framing the larger considerations at hand. We hope you enjoy Professor Noyes’ commentary and the articles that comprise Cancer Nursing’s first special issue on evidence synthesis methods. We further hope that—whether you are interested in the substantive domains addressed in these syntheses, the methods used to achieve them, or both—you find the contents valuable and useful.

We look forward to your comments and questions about this special issue. Feel free to email us at [email protected] and be sure to share your favorite articles and reactions to the issue as a whole on social media using @Cancer_Nursing on Twitter and posting to on Facebook.

R.K. Elswick, Jr, PhD
Virginia Commonwealth University School of Nursing, Richmond, VA, USA
Sarah H. Kagan, PhD, RN
University of Pennsylvania School of Nursing, Philadelphia, PA, USA
G.J. Melendez-Torres, DPhil, RN
University of Exeter College of Medicine and Health, Exeter, England, UK

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