Table D-1, Description of synthesis options - Systematic Reviews of Complex Multicomponent Health Care Interventions

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Guise JM, Chang C, Viswanathan M, et al. Systematic Reviews of Complex Multicomponent Health Care Interventions [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Mar.

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Systematic Reviews of Complex Multicomponent Health Care Interventions [Internet].

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Table D-1Description of synthesis options

#	Description	Example	Some Key Assumptions (not a complete list)^a	Disadvantages	Synthesis Format	Utilizes Framework-Imposed Structure
1	Any intervention instantiation vs. ‘usual care’ (holistic)	Decision aids for people facing treatment decisions^b Collaborative care for management of depression in primary care^c	All intervention instantiations have exchangeable effects The controls are comparable	The summary effect may not be applicable	Qualitative Quantitative	No
2	Compare subclasses of intervention instantiations (subgroups of mutually exclusive subgroups of interventions)	Pulmonary rehabilitation interventions for chronic obstructive pulmonary disease	[Additional assumptions over #1] Intervention instantiations are exchangeable within a subclass Subclass effects are exchangeable Between-subclass differences are consistent	May need more studies than #1 Between-class comparisons may not be observed Challenging to do qualitatively	Qualitative Quantitative	Yes – grouping interventions in classes
3	Explain interventions by specific characteristics of interventions/components	Quality improvement and knowledge transfer interventions for diabetes management^d	[Additional assumptions over #1] Total effect is decomposed as a function of component effects.	May need large number of studies Some effects may not be identifiable Challenging to do qualitatively	Qualitative Quantitative	Yes– decomposition of main effects into component effects

a: Assumptions specific to an analysis choice (e.g., network meta-analysis, or vote counting) are not listed.
b: Stacey D, Bennett CL, Barry MJ, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2011;10(10).
c: Bower P, Gilbody S, Richards D, et al. Collaborative care for depression in primary care. Making sense of a complex intervention: systematic review and meta-regression. Br J Psychiatry. 2006;189:484–93. [PubMed: 17139031].
d: Tricco AC, Ivers NM, Grimshaw JM, et al. Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012 Jun 16;379(9833):2252–61. [PubMed: 22683130].

From: Appendix D, Analytic Models and Description of Synthesis Options

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Guise JM, Chang C, Viswanathan M, et al. Systematic Reviews of Complex Multicomponent Health Care Interventions [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Mar. Table D-1, Description of synthesis options.
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