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Synthesising quantitative and qualitative evidence to inform guidelines on complex interventions: clarifying the purposes, designs and outlining some methods
Open accessAbstract
Guideline developers are increasingly dealing with more difficult decisions concerning whether to recommend complex interventions in complex and highly variable health systems. There is greater recognition that both quantitative and qualitative evidence can be combined in a mixed-method synthesis and that this can be helpful in understanding how complexity impacts on interventions in specific contexts. This paper aims to clarify the different purposes, review designs, questions, synthesis methods and opportunities to combine quantitative and qualitative evidence to explore the complexity of complex interventions and health systems. Three case studies of guidelines developed by WHO, which incorporated quantitative and qualitative evidence, are used to illustrate possible uses of mixed-method reviews and evidence. Additional examples of methods that can be used or may have potential for use in a guideline process are outlined. Consideration is given to the opportunities for potential integration of quantitative and qualitative evidence at different stages of the review and guideline process. Encouragement is given to guideline commissioners and developers and review authors to consider including quantitative and qualitative evidence. Recommendations are made concerning the future development of methods to better address questions in systematic reviews and guidelines that adopt a complexity perspective.
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“the first author read all the charted data (including study aims, methods, and samples) before coding each study’s findings to preserve its original context and ensure that its findings could be fully understood without misinterpretation [39].”
From Experiences of Using Digital Mindfulness-Based Interventions: Rapid Scoping Review and Thematic Synthesis (2023) · cites this paper as [39]
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Metadata
- Authors
- Noyes, J., Booth, A., Moore, G., Flemming, K., Tunçalp, Ö., & Shakibazadeh, E.
- Affiliations
- Bangor University (GB)
- University of Sheffield (GB)
- Cardiff University (GB)
- University of York (GB)
- World Health Organization (CH)
- Tehran University of Medical Sciences (IR)
- Corresponding author
- Noyes, Jane
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2019-01
- Volume
- 4
- Issue
- Suppl 1
- Pages
- e000893
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC6350750
- OpenAlex
- W2906715785
- Cited by
- 497
- References
- 63
- Citations by year
- 2026: 70 · 2025: 80 · 2024: 83 · 2023: 66 · 2022: 51 · 2021: 83 · 2020: 49 · 2019: 13
- Type
- conference abstract
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Funding provided by the World Health Organization Department of Maternal, Newborn, Child and Adolescent Health through a grant received from the United States Agency for International Development.
- 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
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- complex interventions, evidence synthesis, clinical guideline development, WHO guidelines, complexity perspective
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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