Complex interventions and their implications for systematic reviews: a pragmatic approach
Complex interventions and their implications for systematic reviews: a pragmatic approach
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DOI：
10.1016/j.jclinepi.2013.06.004
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发表时间：
2013-11-01
影响因子：
7.2
通讯作者：
Welch, Vivian
中科院分区：
文献类型：
--
作者：
Petticrew, Mark;Anderson, Laurie;Welch, Vivian
复杂的干预措施给系统评价带来了独特的挑战。当前的争论往往集中在描述复杂性上，而不是提供如何应对复杂性的指导。在 2009 年至 2012 年期间的一系列会议上，我们回顾了审稿人将复杂性观点纳入系统审评中可以采取的挑战和实际步骤。基于此，我们概述了一种处理复杂性的务实方法，对于任何评论来说，首先要明确定义研究问题。我们认为，对复杂干预措施的审查本身可以是简单的，也可以是复杂的，具体取决于要回答的问题。在对复杂干预措施进行系统审查和评估时，首先确定复杂性的来源，然后将干预措施中复杂性的各个方面映射到适当的证据来源（例如特定类型的定量或定性研究）将很有帮助。尽管我们专注于系统评价，但一般方法也适用于旨在评估复杂干预措施的初级研究。尽管这些例子来自医疗保健，但该方法也可以应用于其他部门（例如社会政策或国际发展）。最后我们得出的结论是，系统评价应该遵循奥卡姆剃刀原则：解释应该尽可能复杂，而不是更多。 (c) 2013 Elsevier Inc. 保留所有权利。
Complex interventions present unique challenges for systematic reviews. Current debates tend to center around describing complexity, rather than providing guidance on what to do about it. At a series of meetings during 2009-2012, we met to review the challenges and practical steps reviewer could take to incorporate a complexity perspective into systematic reviews. Based on this, we outline a pragmatic approach to dealing with complexity, beginning, as for any review, with clearly defining the research question(s). We argue that reviews of complex interventions can themselves be simple or complex, depending on the question to be answered. In systematic reviews and evaluations of complex interventions, it will be helpful to start by identifying the sources of complexity, then mapping aspects of complexity in the intervention onto the appropriate sources of evidence (such as specific types of quantitative or qualitative study). Although we focus on systematic reviews, the general approach is also applicable to primary research that is aimed at evaluating complex interventions. Although the examples are drawn from health care, the approach may also be applied to other sectors (e.g., social policy or international development). We end by concluding that systematic reviews should follow the principle of Occam's razor: explanations should be as complex as they need to be and no more. (c) 2013 Elsevier Inc. All rights reserved.