Cited by 101Meta-analysis and systematic reviewsHealth Policy Implementation ScienceDelphi Technique in Research

Investigating complexity in systematic reviews of interventions by using a spectrum of methods

Anderson, Laurie M., Oliver, Sandy R., Michie, Susan, Rehfuess, Eva, Noyes, Jane, Shemilt, Ian·2013·Journal of Clinical Epidemiology

Abstract

Systematic reviews framed by PICOS (Populations, Interventions, Comparisons, Outcomes, and Study designs) have been valuable for synthesizing evidence about the effects of interventions. However, this framework is limited in its utility for exploring the influence of variations within populations or interventions, or about the mechanisms of action or causal pathways thought to mediate outcomes, other contextual factors that might similarly moderate outcomes, or how and when these mechanisms and elements interact. Valuable insights into these issues come from configurative as well as aggregative methods of synthesis. This article considers the range of evidence that can be used in systematic reviews of interventions to investigate complexity in terms of potential sources of variation in interventions and their effects, and presents a continuum of purposes for, and approaches to, evidence synthesis. Choosing an appropriate synthesis method takes into account whether the purpose of the synthesis is to generate, explore, or test theories. Taking complexity into account in a synthesis of economic evidence similarly shifts emphasis from evidence synthesis strategies focused on aggregation toward configurative strategies that aim to develop, explore, and refine (in advance of testing) theories or explanations of how and why interventions are more or less resource intensive, costly or cost-effective in different settings, or when implemented in different ways.

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Crossref · 10.1016/j.jclinepi.2013.06.014

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Authors
Anderson, L. M., Oliver, S. R., Michie, S., Rehfuess, E., Noyes, J., & Shemilt, I.
Affiliations
  • University of Washington (US)
  • University of London (GB)
  • University College London (GB)
  • Ludwig-Maximilians-Universität München (DE)
  • Bangor University (GB)
  • University of Cambridge (GB)
Corresponding author
Anderson, Laurie M.
Venue
Journal of Clinical Epidemiology
Publisher
Elsevier BV
Published
2013-11
Volume
66
Issue
11
Pages
1223-1229
ISSN
0895-4356 (ISSN-L)
OpenAlex
W2027121083
Cited by
101
References
37
Citations by year
2026: 1 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 10 · 2020: 5 · 2019: 8 · 2018: 9 · 2017: 19 · 2016: 12 · 2015: 8 · 2014: 8 · 2013: 4
FWCI
2.16
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Social Sciences › Sociology and Political Science › Delphi Technique in Research
Keywords
mechanism of action, causal pathways, intervention moderators, cost-effectiveness, theory testing
MeSH terms
Humans, Research Design, Review Literature as Topic

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