RT Journal Article
SR Electronic
T1 Taking account of context in systematic reviews and guidelines considering a complexity perspective
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e000840
DO 10.1136/bmjgh-2018-000840
VO 4
IS Suppl 1
A1 Andrew Booth
A1 Graham Moore
A1 Kate Flemming
A1 Ruth Garside
A1 Nigel Rollins
A1 Özge Tunçalp
A1 Jane Noyes
YR 2019
UL http://gh.bmj.com/content/4/Suppl_1/e000840.abstract
AB Systematic review teams and guideline development groups face considerable challenges when considering context within the evidence production process. Many complex interventions are context-dependent and are frequently evaluated within considerable contextual variation and change. This paper considers the extent to which current tools used within systematic reviews and guideline development are suitable in meeting these challenges. The paper briefly reviews strengths and weaknesses of existing approaches to specifying context. Illustrative tools are mapped to corresponding stages of the systematic review process. Collectively, systematic review and guideline production reveals a rich diversity of frameworks and tools for handling context. However, current approaches address only specific elements of context, are derived from primary studies which lack information or have not been tested within systematic reviews. A hypothetical example is used to illustrate how context could be integrated throughout the guideline development process. Guideline developers and evidence synthesis organisations should select an appropriate level of contextual detail for their specific guideline that is parsimonious and yet sensitive to health systems contexts and the values, preferences and needs of their target populations.