RAMESES publication standards: realist syntheses

Abstract

BackgroundThere is growing interest in realist synthesis as an alternative systematic review method. This approach offers the potential to expand the knowledge base in policy-relevant areas - for example, by explaining the success, failure or mixed fortunes of complex interventions. No previous publication standards exist for reporting realist syntheses. This standard was developed as part of the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) project. The project's aim is to produce preliminary publication standards for realist systematic reviews.MethodsWe (a) collated and summarized existing literature on the principles of good practice in realist syntheses; (b) considered the extent to which these principles had been followed by published syntheses, thereby identifying how rigor may be lost and how existing methods could be improved; (c) used a three-round online Delphi method with an interdisciplinary panel of national and international experts in evidence synthesis, realist research, policy and/or publishing to produce and iteratively refine a draft set of methodological steps and publication standards; (d) provided real-time support to ongoing realist syntheses and the open-access RAMESES online discussion list so as to capture problems and questions as they arose; and (e) synthesized expert input, evidence syntheses and real-time problem analysis into a definitive set of standards.ResultsWe identified 35 published realist syntheses, provided real-time support to 9 on-going syntheses and captured questions raised in the RAMESES discussion list. Through analysis and discussion within the project team, we summarized the published literature and common questions and challenges into briefing materials for the Delphi panel, comprising 37 members. Within three rounds this panel had reached consensus on 19 key publication standards, with an overall response rate of 91%.ConclusionThis project used multiple sources to develop and draw together evidence and expertise in realist synthesis. For each item we have included an explanation for why it is important and guidance on how it might be reported. Realist synthesis is a relatively new method for evidence synthesis and as experience and methodological developments occur, we anticipate that these standards will evolve to reflect further methodological developments. We hope that these standards will act as a resource that will contribute to improving the reporting of realist syntheses.To encourage dissemination of the RAMESES publication standards, this article is co-published in the Journal of Advanced Nursing and is freely accessible on Wiley Online Library (http://www.wileyonlinelibrary.com/journal/jan).Please see related article http://www.biomedcentral.com/1741-7015/11/20 and http://www.biomedcentral.com/1741-7015/11/22

Time to challenge the spurious hierarchy of systematic over narrative reviews?

“…It may or may not define its reference body of studies using systematic search methods and inclusion/exclusion criteria, but its primary focus is on the essential tasks of induction and interpretation in relation to the defined sample for the purpose of advancing theoretical understanding 17. A realist review considers the “generative causality,” in which particular mechanisms (for example, peer influence) produce particular outcomes (for example, smoking cessation) in some circumstances (for example, when societal disapproval of smoking is high) but not others (for example, in cultures where smoking is still widely viewed as a mark of sophistication) 27. A meta‐narrative review maps the storyline of a research tradition over time 28.…”

Collective action for knowledge mobilisation: a realist evaluation of the Collaborations for Leadership in Applied Health Research and Care

“…35 Realist review is a theory-driven method of synthesising knowledge, which is grounded in the realist philosophy of science. 36 It involves 'an iterative process aimed at uncovering the theories that inform decisions and actions'. 37 For pragmatic reasons, we undertook a rapid realist review whereby the realist approach to knowledge synthesis is employed in resource-limited circumstances.…”

“…36,59 The main databases searched were limited to the health and behavioural sciences and included Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, PubMed, MEDLINE and JSTOR. A 'snowball' process was used to check and retrieve references cited in accessed articles if they were deemed to be relevant to the review.…”

“…Methodological 'filters' were intentionally not used, to avoid missing any papers that could be relevant to the review. 36 The search was not confined to research studies, and included other evidence, for example case studies, column papers and reports.…”

Multimedia psychoeducational interventions to support patient self-care in degenerative conditions: A realist review

“…Consequently, we examined the literature not only to gauge the outcomes of interventions but to identify their underpinning theories (whether explicit or implicit), use of resources, mechanisms at work and the impact of context. We sought to conceptualise these factors in ways that are consistent with our realist assumptions, so that we could make recommendations to those producing and implementing multimedia psycho-educational interventions on which resources, 6 in what contexts are likely to trigger mechanisms that will produce the desired outcomes (Wong, Greenhalgh, Westhorp, Buckingham, & Pawson, 2013).…”