Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field.
Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field.
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DOI：
10.1258/1355819054308576
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发表时间：
2005-07-01
影响因子：
2.4
通讯作者：
Popay, Jennie
中科院分区：
文献类型：
--
作者：
Mays, Nicholas;Pope, Catherine;Popay, Jennie
政策制定者和管理人员在作出关于政策和服务组织的决定时，总是使用广泛的证据来源。然而，他们面临着越来越大的压力，要求他们采取更系统的方法来利用复杂的证据库。决策者必须解决以下复杂问题：要解决的问题的性质和重要性；拟议干预措施的性质；其不同影响；成本效益；可接受性等。这意味着，仅有科克伦式的审查是不够的。相反，它们需要获得高质量证据的综合，包括研究和非研究来源，以及定性和定量的研究结果。没有单一的商定框架来综合这种不同形式的证据，许多可能适用于这种努力的方法都是为定性或定量综合和(或)分析原始数据而设计的。本文描述了为决策审查和综合定性和定量证据的关键阶段，并展望了可能提供前进方向的各种策略。我们确定了四种基本方法：叙事性(包括传统的“文献评论”和更明确的方法，如“主题分析”、“叙事综合”、“现实主义综合”和“元叙事映射”)、定性(利用“元人种学”和“定性跨案例分析”等技术将所有现有证据转换为定性形式)、定量(使用‘定量案例调查’或‘内容分析’等技术将所有证据转换为定量形式)和贝叶斯元分析和决策分析(可将不同结果的偏好等定性证据转换为定量形式或“权重”，用于定量综合)。方法的选择将取决于审查的目的和现有证据的性质，而且往往需要一种以上的方法。
Policy-makers and managers have always used a wide range of sources of evidence in making decisions about policy and the organization of services. However, they are under increasing pressure to adopt a more systematic approach to the utilization of the complex evidence base. Decision-makers must address complicated questions about the nature and significance of the problem to be addressed; the nature of proposed interventions; their differential impact; cost-effectiveness; acceptability and so on. This means that Cochrane-style reviews alone are not sufficient. Rather, they require access to syntheses of high-quality evidence that include research and non-research sources, and both qualitative and quantitative research findings. There is no single, agreed framework for synthesizing such diverse forms of evidence and many of the approaches potentially applicable to such an endeavour were devised for either qualitative or quantitative synthesis and/or for analysing primary data. This paper describes the key stages in reviewing and synthesizing qualitative and quantitative evidence for decision-making and looks at various strategies that could offer a way forward. We identify four basic approaches: narrative (including traditional 'literature reviews' and more methodologically explicit approaches such as 'thematic analysis', 'narrative synthesis', 'realist synthesis' and 'meta-narrative mapping'), qualitative (which convert all available evidence into qualitative form using techniques such as 'meta-ethnography' and 'qualitative cross-case analysis'), quantitative (which convert all evidence into quantitative form using techniques such as 'quantitative case survey' or 'content analysis') and Bayesian meta-analysis and decision analysis (which can convert qualitative evidence such as preferences about different outcomes into quantitative form or 'weights' to use in quantitative synthesis). The choice of approach will be contingent on the aim of the review and nature of the available evidence, and often more than one approach will be required.