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Feasibility of Using Qualitative Analysis for Systematic Reviews of Complex Inter

使用定性分析对复杂的内部系统进行系统审查的可行性

基本信息

批准号：
8733515
负责人：
Leila Catherine Kahwati
金额：
$ 1万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2015-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8733515
关键词：
Feasibility Using Qualitative Analysis Systematic

项目摘要

DESCRIPTION (provided by applicant): The objective of this study is to determine the feasibility of using qualitative comparative analysis (QCA) within systematic reviews of complex health interventions to enrich review results through identification of key intervention features associated with effectiveness. Systematic reviews are the foundation for evidence- based health care, and form the basis for clinical guidelines, quality measures, and health policy. However, reviews of complex interventions are challenging because of the large degree of clinical and methodological heterogeneity that is often present among included studies. Review investigators need new methods to complement existing methods of review for complex interventions. We expect QCA to be used to analyze study-level covariates to better explore heterogeneity, and may offer an advantage over existing methods because of its origins as a method to study complex phenomena. QCA is a case-oriented, nonprobabilistic technique based on set-theoretic causal relationships (i.e., set, superset, and subset) between independent and dependent variables. It shares features of both quantitative and qualitative methods and produces results through a process of logical minimization using Boolean algebra. We will apply QCA to an already completed Agency for Healthcare Research and Quality-funded comparative effectiveness review of interventions to improve medication adherence. This review exemplifies a complex intervention review because it included studies with multiple intervention targets and agents, vastly different intervention components, and differences in duration and intensity of intervention. The proposed study is the first such application of QCA to systematic reviews. The specific aims are to (1) use QCA to determine which intervention features alone or in combination are related to improved medication adherence among outpatients who are prescribed long-term medication therapy for chronic conditions, and (2) describe our process for applying QCA within the context of the systematic review of interventions to increase medication adherence. We will treat each included study within the medication adherence review as a unit of analysis and will use QCA to evaluate study covariates for their relationship to the treatment effect. In this context, we would express our findings in set-theoretic statements of necessity and sufficiency. For example, "Complex health interventions to improve medication adherence require component X and either component A or D, or the combination of B and C." We expect that this work will determine the initial feasibility f using QCA within a systematic review context. If feasible, QCA will significantly enhance review methods for complex interventions because it applies a fundamentally different paradigm (the use of set relationships) for evaluating causal relationships in addition to taking advantage of existing heterogeneity within complex health intervention reviews.

描述（由申请方提供）：本研究的目的是确定在复杂健康干预措施的系统性综述中使用定性比较分析（QCA）的可行性，以通过识别与有效性相关的关键干预措施特征来丰富综述结果。系统评价是循证卫生保健的基础，也是临床指南、质量措施和卫生政策的基础。然而，复杂干预措施的审查是具有挑战性的，因为纳入的研究中经常存在很大程度的临床和方法学异质性。审查研究者需要新的方法来补充复杂干预措施的现有审查方法。我们期望QCA用于分析研究水平的协变量，以更好地探索异质性，并可能提供优于现有方法的优势，因为它的起源是一种研究复杂现象的方法。QCA是一种基于集合论因果关系（即，集合，超集和子集）之间的独立和因变量。它共享定量和定性方法的特征，并通过使用布尔代数的逻辑最小化过程产生结果。我们将把QCA应用于已经完成的医疗保健研究和质量资助的干预措施的比较有效性审查机构，以提高药物依从性。本综述证实了一项复杂的干预综述，因为它包括了多个干预靶点和药物的研究，不同的干预成分，以及干预持续时间和强度的差异。该研究是QCA在系统评价中的首次应用。具体目的是（1）使用QCA来确定哪些干预功能单独或组合与改善门诊患者的药物依从性有关，这些患者因慢性疾病接受长期药物治疗，以及（2）描述我们在系统评价干预措施的背景下应用QCA以提高药物依从性的过程。我们将药物依从性审查中纳入的每项研究作为一个分析单元，并将使用QCA评价研究协变量与治疗效果的关系。在这种情况下，我们将表达我们的发现在集合论的必要性和充分性的陈述。例如，“改善药物依从性的复杂健康干预措施需要组分X和组分A或D，或B和C的组合。“我们希望这项工作将确定在系统性评价背景下使用QCA的初步可行性。如果可行，QCA将显著增强复杂干预措施的审查方法，因为它除了利用复杂健康干预措施审查中现有的异质性外，还应用了一种根本不同的范式（使用集合关系）来评估因果关系。