Characteristics make this a meta-analysis

Statistical Combination: It goes beyond a systematic review by using statistical methods (e.g., fixed-effect or random-effects models) to mathematically aggregate the data (e.g., effect sizes, odd ratios, mean differences) from the included studies.2

Pooled Estimate: The primary output is a single, more precise measure of effect (often visualized in a forest plot ). This single number (e.g., a mean difference or standardized effect size) represents the true effect of the intervention across the combined population of all studies, offering greater statistical power than any individual study.3

Assessment of Heterogeneity: It includes statistical tests (e.g., $I^2$ statistic) to quantify the degree of variability (heterogeneity) in the results across the different studies.

In the selected article, Smith et al. (2023) is identified as a meta-analysis because it not only gathered multiple randomized controlled trials (RCTs) on telehealth but also used techniques like calculating a pooled weighted mean difference for A1c levels and used a forest plot to visually display the results and the overall effect size.

2. Inclusion/Exclusion Criteria and Article Selection

Clarity of Criteria

The inclusion and exclusion criteria in the hypothetical article by Smith et al. (2023) were clearly stated and provided the necessary framework for replication.

Inclusion Criteria (Hypothetical Examples):

Published in a peer-reviewed journal between 2013 and 2023.

Study design must be a Randomized Controlled Trial (RCT).

Participants must be adults (age 18+) with a diagnosis of Type 2 Diabetes Mellitus.

The intervention must be a nurse-led intervention delivered via telehealth (e.g., phone, video, app).

Outcome measures must include A1c and/or a validated self-efficacy scale.

Exclusion Criteria (Hypothetical Examples):

Non-English language studies.

Studies with less than 50 participants.

Studies with a follow-up period shorter than three months.

Interventions delivered solely in-person or led primarily by a physician or pharmacist.

Article Selection Process

The selection process was outlined as follows:

Systematic Search: Databases (e.g., CINAHL, PubMed, Cochrane Library) were searched using specific key terms (e.g., "telehealth," "nurse," "diabetes," "A1c").

Initial Screening: Two independent reviewers (Smith and co-author Jones) screened titles and abstracts for relevance against the criteria.

Full-Text Review: The same two reviewers obtained the full text of potentially relevant articles and independently assessed them against the inclusion/exclusion criteria.

Conflict Resolution: Any disagreements between the two reviewers regarding study inclusion were resolved through consensus or by consulting a third reviewer (Dr. Williams).

Quality Assessment: Each included RCT was formally appraised for risk of bias (e.g., using the Cochrane Risk of Bias tool).

Sample Answer

Characteristics of a Meta-Analysis:

A meta-analysis is a systematic statistical approach that combines the results from multiple independent studies to produce a single, pooled estimate of effect. This approach is considered the highest level of evidence on the hierarchy, just below systematic reviews of meta-analyses. The key characteristics that define it are:

Systematic Review Foundation: It begins with a systematic, rigorous search and appraisal process to identify all relevant research on a focused clinical question (like an RCT).