Considering Complexity in Systematic Reviews of InterventionsIntroducing a series of methodological articles on considering complexity in systematic reviews of interventions
Section snippets
Background
Systematic reviews of public health and health care interventions attempt to synthesize high-quality timely research evidence to inform decision making. Practitioners use systematic reviews to find out if an intervention is effective in a given situation, health care consumers use them to weigh potential benefits and harms of alternative courses of care, and policy makers use them to help make choices intended to maximize health and well-being for society. Systematic review authors are
Complex systems
Review of the sentinel work in the field of complex (adaptive) systems research as applied to public health, health care, and social and organizational systems is beyond the scope of this series and can be found elsewhere [1], [2], [3], [4], [5], [6]. However, a conceptual vocabulary of complex adaptive systems may provide a helpful start. One way to begin to understand the interplay between professionals, consumers, and the organizational systems in public health and health care delivery is to
Sources of complexity in interventions
The evaluation of complex interventions, and the need to synthesize evidence on the effects of such interventions, has driven the development of the recent Medical Research Council (MRC) complex interventions framework [9], which moved beyond a more traditional model of drug development [10] (Fig. 1) that traces in a linear fashion the passage of drugs in development through phases 0 and 1 through to phase 4. In its place came an iterative model (Fig. 2) that more accurately reflects how
Considering complexity in systematic reviews of interventions
To what degree do systematic review authors need to make distinctions between simple or complex interventions? Fundamentally, this depends on how the review question is framed and the level of explanation sought about core intervention dynamics and the properties of systems in which the intervention is implemented. For the purpose of the work undertaken in this series of articles, clarity of terminology and context is important. Characteristics of a complex intervention have been defined as
Montebello meeting on systematic reviews of complex interventions
In January 2012, the University of Ottawa, in collaboration with the Ottawa Hospital Research Institute, and with support from The Cochrane Collaboration's Methods Innovation Fund, held a meeting of international experts in Montebello, Quebec, to discuss methodological issues that arise when synthesizing evidence about the effects of complex public health and health care system interventions. Experts from Europe, North American, and Australia gathered to discuss defining and mapping complexity,
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Identifying, documenting and examining heterogeneity in systematic reviews of complex interventions
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Cited by (50)
Scoping Reviews of the Microbiology Literature: Methods and Payoffs
2021, Clinical Microbiology NewsletterCitation Excerpt :While a full explication of the types of complexity that can be encountered during SRMAs is beyond the scope of this article, they are detailed in the literature. Generally, they include intervention complexity, implementation complexity, and context complexity [11–13]. Importantly, the literature suggests choosing an aspect of complexity to focus on during SRMAs [14].
Contacting authors by telephone increased response proportions compared with emailing: results of a randomized study
2019, Journal of Clinical EpidemiologyToward a theory-led metaframework for considering socioeconomic health inequalities within systematic reviews
2018, Journal of Clinical EpidemiologyStructured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches
2018, Journal of Clinical EpidemiologyNode-making process in network meta-analysis of nonpharmacological treatment are poorly reported
2018, Journal of Clinical EpidemiologyTen recommendations for assessing the comparative effectiveness of therapeutic medical devices: a targeted review and adaptation
2018, Journal of Clinical EpidemiologyCitation Excerpt :Finally, 12 publications were included in evidence synthesis (see flow diagram of literature selection in Appendix A Figure at www.jclinepi.com). Among the 12 included publications for the development of recommendations on planning and conducting a SR of CE of TMDs, eight [15–22] described the FSRCIs, one publication [23] on logic models that was referred to the FSRCIs [15], and three publications [24–26] dealt with the evaluation of TMDs or similar technologies. The characteristics of the publications are described in Appendix C Table at www.jclinepi.com.
Conflict interest: None.