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Systematic Reviews of Complex Multicomponent Health Care Interventions
Research White Papers
Investigators: Jeanne-Marie Guise, MD, MPH, Christine Chang, MD, MPH, Meera Viswanathan, PhD, Susan Glick, MD, Jonathan Treadwell, PhD, Craig A Umscheid, MD, MSCE, Evelyn Whitlock, MD, MPH, Rochelle Fu, PhD, Elise Berliner, PhD, Robin Paynter, MLS, Johanna Anderson, MPH, Pua Motu'apuaka, BS, and Tom Trikalinos, PhD.
Author Information and AffiliationsStructured Abstract
Objective:
The purpose of this report is to outline approaches to address the challenges of conducting systematic reviews of complex multicomponent health care interventions.
Methods:
We performed a literature scan and conducted semi-structured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions, or organizational leaders who implement complex multicomponent interventions in health care.
Results:
Challenges identified include: a lack of consistent terminology for such interventions (e.g., complex; multicomponent; multidimensional; multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from more holistic to individual component analytic approaches; and incomplete and inconsistent reporting in primary and secondary studies of those elements critical to understanding the success and impact of such interventions, such as the methods used to implement the intervention, and the context in which it is implemented.
Conclusions:
We provided a framework to understand the spectrum of conceptual and analytic approaches and an initial list of critical reporting elements for primary and secondary studies of multicomponent interventions. This information will help reviewers understand the options and tradeoffs available for such reviews.
Contents
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. 290-2012-00004-C. Prepared by: Scientific Resource Center, Portland, OR
Suggested citation:
Guise JM, Chang C, Viswanathan M, Glick S, Treadwell J, Umscheid C, Whitlock E, Fu R, Berliner E, Paynter R, Anderson J, Motu'apuaka M, Trikalinos T. Systematic Reviews of Complex Multicomponent Health Care Interventions. Research White Paper. AHRQ Publication No. 14-EHC003-EF. Rockville, MD: Agency for Healthcare Research and Quality. March 2014. www.effectivehealthcare.ahrq.gov/reports/final.cfm.
This report is based on research conducted by the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers' Methods Working Group. The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information (i.e., in the context of available resources and circumstances presented by individual patients).
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.
None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.
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.ahrq.gov
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