Series: AHRQ Series on Complex Intervention Systematic Reviews
AHRQ series on complex intervention systematic reviews—paper 3: adapting frameworks to develop protocols

https://doi.org/10.1016/j.jclinepi.2017.06.013Get rights and content
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Abstract

Background

Once a proposed topic has been identified for a systematic review and has undergone a question formulation stage, a protocol must be developed that specifies the scope and research questions in detail and outlines the methodology for conducting the systematic review.

Rationale

Framework modifications are often needed to accommodate increased complexity. We describe and give examples of adaptations and alternatives to traditional analytic frameworks.

Discussion

This article identifies and describes elements of frameworks and how they can be adapted to inform the protocol and conduct of systematic reviews of complex interventions. Modifications may be needed to adapt the population, intervention, comparators, and outcomes normally used in protocol development to successfully describe complex interventions; in some instances, alternative frameworks may be better suited. Possible approaches to analytic frameworks for complex interventions that illustrate causal and associative linkages are outlined, including time elements, which systematic reviews of complex interventions may need to address. The need for and specifics of the accommodations vary with details of a specific systematic review. This in turn helps determine whether traditional frameworks are sufficient, can be refined, or if alternate frameworks must be adopted.

Keywords

Complex interventions
Evidence-based medicine
Review literature as topic
Systematic reviews
Research design
Analytic frameworks

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Financial support: This project was funded under Contract No: Scientific Resource Center for the EPC Program (HHSA290201200004C), Regents of the University of Minnesota (HHSA290201500008I), ECRI Institute (HHSA290201500005I), John Hopkins University (HHSA290201500006I), RAND Corporation (HHSA290201500010I); from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, and Veterans Affairs Diabetes Quality Enhancement Research Initiative (DIB 98-001).

Conflict of interest: The authors have no conflicts of interest to report. The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the US Department of Health and Human Services.