AHRQ series on complex intervention systematic reviews—paper 5: advanced analytic methods

Pigott, Therese D.; Noyes, Jane; Umscheid, Craig A.; Myers, Evan R.; Morton, Sally C.; Fu, Rongwei; Sanders-Schmidler, Gillian; Devine, Beth; Murad, M. Hassan; Kelly, Michael P.; Fonnesbeck, Christopher; Kahwati, Leila C.; Beretvas, S. Natasha

doi:10.1016/j.jclinepi.2017.06.015

Cited by 30 publications

(40 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…• Health systems often require evidence summaries that are completed rapidly (i.e., in [4][5][6][7][8][9][10][11][12] weeks or less) with succinct, easy-to-grasp conclusions with practical guidance for action even if the evidence is weak or inconclusive, and layered information presentation.…”

Section: Key Pointsmentioning

confidence: 99%

“…Moreover, the EPC Program has developed considerable expertise in performing systematic reviews of complex multicomponent interventions. [2][3][4][5][6][7][8][9] However, the program has not previously examined the scope of topics for which health systems seek evidence or how health systems access and use evidence-for what types of decisions and at what point in the decisionmaking process.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Framework for Conceptualizing Evidence Needs of Health Systems

Schoelles¹,

Umscheid²,

Lin³

et al. 2017

Self Cite

View full text Add to dashboard Cite

PrefaceThe Agency for Healthcare Research and Quality (AHRQ), through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public-and private-sector organizations in their efforts to improve the quality of health care in the United States.The reports and assessments provide organizations with comprehensive, science-based information on common, costly medical conditions and new health care technologies and strategies. The EPCs systematically review the relevant scientific literature on topics assigned to them by AHRQ and conduct additional analyses when appropriate prior to developing their reports and assessments.To improve the scientific rigor of these evidence reports, AHRQ supports empiric research by the EPCs to help understand or improve complex methodologic issues in systematic reviews. These methods research projects are intended to contribute to the research base in and be used to improve the science of systematic reviews. They are not intended to be guidance to the EPC program, although may be considered by EPCs along with other scientific research when determining EPC program methods guidance.AHRQ expects that the EPC evidence reports and technology assessments will inform individual health plans, providers, and purchasers as well as the health care system as a whole by providing important information to help improve health care quality. The reports undergo peer review prior to their release as a final report.If AcknowledgmentsThe authors gratefully acknowledge the input of the late Robert Lewis Kane, M.D., who was a member of our workgroup until his unexpected death on March 6, 2017. Dr. Kane stimulated the conversation of our workgroup with his ideas and challenges, and inspired creation of the initial framework for our efforts (See Appendix B).The authors also acknowledge two health system representatives, Lucy Savitz, Ph.D., and Charles P. Friedman, Ph.D. for their feedback on our initial framework and draft report. A Framework for Conceptualizing Evidence Needs of Health Systems Structured AbstractObjectives. To develop a framework for understanding the evidence needs of health systems to inform the AHRQ EPC Program future efforts.Data sources. Three data sources were used: (a) peer-reviewed literature from a systematic search of English-language publications in MEDLINE from January 2007-April 2017, (b) original data from four programs serving health system requests for evidence syntheses, and (c) input during a face-to-face meeting at AHRQ in June 2017 from health system stakeholders and EPC investigators.Methods. Data were synthesized narratively and thematically. We developed an initial framework to guide discussion and qualitative analysis. We built consensus around themes and refinement of the framework through weekly phone conferences, electronic communications, and a face-to-face meeting of workgroup members and health systems experts. Results.From the literature review, we found that health systems seek evidence to ...

show abstract

Section: Key Pointsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Framework for Conceptualizing Evidence Needs of Health Systems

Schoelles¹,

Umscheid²,

Lin³

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…It will need to be applied in a dynamic multidimensional environment. The planned review will therefore be performed according to the methodological standards for complex reviews [21][22][23][24][25][26][27][28].…”

Section: Methodsmentioning

confidence: 99%

“…We will perform qualitative (narrative) synthesis of included studies. We will perform this process through thematic synthesis for each proposed component of the complex intervention pathway [26]. We plan to analyze, synthesize, and grade the quality of the body of evidence across outcomes with regard to individual pathway components [39].…”

Section: Data Synthesismentioning

confidence: 99%

Proposed pathway for patients undergoing enhanced recovery after spinal surgery: protocol for a systematic review

et al. 2020

View full text Add to dashboard Cite

Background: The best evidence-enhanced recovery care pathway is yet to be defined for patients undergoing spinal surgery. Minimally invasive surgery, multimodal analgesia, early mobilization, and early postoperative nutrition have been considered as critical components of enhanced recovery in spinal surgery (ERSS). The objective of this study will be to synthesize the evidence underpinning individual components of a proposed multidisciplinary enhanced recovery pathway for patients undergoing spinal surgery. Methods: This is the study protocol for a systematic review of complex interventions. Our team identified 22 individual care components of a proposed pathway based on clinical practice guidelines and published reviews. We will include systematic reviews and meta-analysis, randomized controlled trials, non-randomized controlled trials, and observational studies in adults or pediatric patients evaluating any one of the pre-determined care components. Our primary outcomes will be all-cause mortality, morbidity outcomes (e.g., pulmonary, cardiac, renal, surgical complications), patient-reported outcomes and experiences (e.g., pain, quality of care experience), and health services outcomes (e.g., length of stay and costs). We will search the following databases (1990 onwards) MEDLINE, EMBASE, and Cochrane Library (Cochrane Database of Systematic Reviews and CENTRAL). Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The risk of bias for individual studies will be appraised using appropriate tools. A narrative synthesis will be provided with the information presented in the text and tables to summarize and explain the characteristics and findings of the included studies. Due to clinical and methodological heterogeneity, we do not anticipate to conduct meta-analyses. Confidence in cumulative evidence for each component of care will be classified according to the GRADE system.Discussion: This systematic review will identify, evaluate, and integrate the evidence underpinning individual components of a pathway for patients undergoing spinal surgery. The formation of an evidence-based pathway will allow for the standardization of clinical care delivery within the context of enhanced recovery in spinal surgery. Systematic review registration: PROSPERO CRD42019135289

show abstract

“…This article discusses the process used to develop the series, provides a consolidated definition of complex interventions, and provides questions systematic reviewers can ask to determine whether the subject of their review is a complex intervention Developing protocols for systematic reviews and meta-analyses of complex interventions Scoping questions AHRQ series on complex intervention systematic reviewsdpaper 2: defining complexity, formulating scope, and questions [30] Offers guidance on the earliest stages of a review, particularly on stakeholder engagement and scope and key question formulation. Complex intervention problem formation is an iterative and emergent process that requires careful articulation before the literature review Developing frameworks AHRQ series on complex intervention systematic reviewsdpaper 3: adapting frameworks to develop protocols [31] Examines how to use frameworks to elaborate the research questions and define the study eligibility criteria (i.e., whether and why/how it works) and an analytic framework (or other visual model) to clearly depict how the analysis will address the key research questions, taking into account how the interventions may affect outcomes of interest Developing analytic plans for systematic reviews of complex interventions Best practice analytic methods AHRQ series on complex intervention systematic reviewsdpaper 4: selecting analytic approaches [32] Describes important considerations for choosing analytic approaches for review questions about complex interventions Selecting analytic approaches AHRQ series on complex intervention systematic reviewsdpaper 5: advanced analytic methods [33] Introduces analytic methods that can address four broad questions about complex interventions: intervention. Commonly, public and population health, community and system-level interventions, and those aimed at behavior change are more likely to be complex than simple.…”

Section: How Do I Know If An Intervention Is Complex?mentioning

confidence: 99%

AHRQ series on complex intervention systematic reviews—paper 1: an introduction to a series of articles that provide guidance and tools for reviews of complex interventions

Guise

Chang

Butler

et al. 2017

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

AHRQ series on complex intervention systematic reviews—paper 5: advanced analytic methods

Abstract: The analytic approaches presented in this paper are particularly useful when each primary study differs in components, mechanisms of action, context, implementation, timing, and many other domains.

Cited by 30 publications

References 34 publications

A Framework for Conceptualizing Evidence Needs of Health Systems

A Framework for Conceptualizing Evidence Needs of Health Systems

Proposed pathway for patients undergoing enhanced recovery after spinal surgery: protocol for a systematic review

AHRQ series on complex intervention systematic reviews—paper 1: an introduction to a series of articles that provide guidance and tools for reviews of complex interventions

Contact Info

Product

Resources

About