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

Greenhalgh, Trisha; Thorne, Sally; Malterud, Kirsti

doi:10.1111/eci.12931

Cited by 534 publications

(491 citation statements)

References 43 publications

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“…Greenhalgh et al . noted that data analysis in review papers is often less robust than the screening and appraisal process.…”

Section: Discussionmentioning

confidence: 99%

“…Analytical themes are discussed using the structure of the 3P theory. Three authors (NO'L, NS and AC) were involved at this subjective stage to limit interpretation bias . The GRADE‐CERQual ( g rading of r ecommendations, a ssessment, d evelopment and e valuation– c onfidence in e vidence from r eviews of q ualitative research) tool was used to make an assessment of overall confidence in findings underpinning each theme .…”

Section: Methodsmentioning

confidence: 99%

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‘Bumping along’: a qualitative metasynthesis of challenges to interprofessional placements

et al. 2019

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Context Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed. Objectives This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation. Methods A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage‐process‐product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research). Results We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach. Conclusions In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice‐ready workforce. This in turn will enhance service user outcomes and safety.

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“…Greenhalgh et al . noted that data analysis in review papers is often less robust than the screening and appraisal process.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

‘Bumping along’: a qualitative metasynthesis of challenges to interprofessional placements

et al. 2019

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“…Efforts are underway to develop and test guides for searching, appraising and reporting each of the six review types. Indeed, even the narrative review has resurged as an acceptable base for collecting and interpreting lay and expert opinion on health, ill‐health and health care . The prolific development of acronyms attests to these efforts well beyond the limits of the PICO/PECO/PRISMA guides.…”

Section: Discussionmentioning

confidence: 99%

“…This raises questions about the quality of the evidence published in influential journals, particularly if the findings of randomised or even non‐randomised controlled trials are the preferred standard of clinical evidence as suggested by the Cochrane Collaboration . Apparently, prestigious journals still value the opinions of well‐informed experts, in addition to the results of clinical trials and the practical interpretations of people who experience illness and participate in health care, to inform policy and guide clinical practice …”

Section: Introductionmentioning

confidence: 99%

A typology of systematic reviews for synthesising evidence on health care

MacEntee

2019

Gerodontology

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Objectives The objectives of this paper are to (a) Review published references to systematic reviews; (b) offer a typology of systematic reviews for synthesising evidence on health care; and (c) summarise the guides for designing, reporting and appraising the reviews. Background Systematic reviews play a role in finding, synthesising, transferring and implementing evidence for healthcare policy, practice guidelines and allocation of health resources. They have been particularly successful in confirming or synthesising evidence for health care by meta‐analysing aggregated data from multiple randomised controlled trials. However, concerns about the limitations of evidence from controlled trials have prompted interest in other review methods capable of locating and appraising evidence from more diverse, and possibly more realistic, healthcare situations. Methods An iterative citation‐tracking process with Google Search and grey literature identified 204 papers on previous typologies and methods of systematic reviews. Results and Conclusions There are six types of systematic reviews: narrative; meta‐analysis; scoping; qualitative; umbrella; and realist. Each type has distinct objectives, characteristics and attributes, but with much overlapping of methods and guides. Sensitivity to the need for qualitative evidence on complex human responses to ill‐health and health care has broadened the objectives and methods of health‐related systematic reviews to find, appraise and synthesis useful evidence for practice guidelines, healthcare policy and allocation of health resources.

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“…While their observation of quite significant differences was interesting, what was even more intriguing was their evident assumption in conducting and publishing this comparison that it was relevant by virtue of the systematic reviews signifying superior scholarship. A lively conversation about that assumption ensued on social media, following which I joined forces with two colleagues—both physicians with established track records in methodological writing—to write a discussion paper on what we referred to as the “spurious hierarchy” of systematic over narrative reviews (Greenhalgh, Thorne, & Malterud, ). The point of that paper was to reinvigorate the discussion about why one does a review, and to try to turn the tide against the alarming trend to try to render all review products systematic.…”

mentioning

confidence: 99%