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Question-led systematic reviews: implications for synthesis

Question-led systematic reviews: implications for synthesis. Methods Festival 2006 Sandy Oliver Institute of Education, University of London. Questions, purpose, research activity and items. Implications for searching. Systematic review questions.

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Question-led systematic reviews: implications for synthesis

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  1. Question-led systematic reviews: implications for synthesis Methods Festival 2006 Sandy Oliver Institute of Education, University of London

  2. Questions, purpose, researchactivity and items

  3. Implications for searching

  4. Systematic review questions • 21 systematic reviews coded (so far)= 52 questions • The number of Macro and Micro questions identified:

  5. Systematic review questions • Questions about agency: What are people’s situations and strategies? Example: What are the experiences of 'mothering other-than-normal children'? (Nelson, 2002)

  6. What are the experiences of 'mothering other-than-normal children'?

  7. What are the experiences of 'mothering other-than-normal children'? Meta ethnography • A priori or iterative procedures of review • Numerical or narrative data • ‘Empirical’ or‘conceptual’ data • Most concepts pre-specified or most concepts emergent • Relatively homogeneous or heterogeneous data • Numerical, narrative analysis or quantification of qualitative data in synthesis • Integrative or interpretative synthesis of data

  8. Systematic review questions • Questions of influence: What is the impact? • Example: • ‘Do Hospital-Based Palliative Teams Improve Care for Patients or Families at the End of Life?’ (Higginson, 2002)

  9. ‘Do Hospital-Based Palliative Teams Improve Care for Patients or Families at the End of Life?’

  10. ‘Do Hospital-Based Palliative Teams Improve Care for Patients or Families at the End of Life?’ Statistical meta analysis • A priori or iterative procedures of review • Numerical or narrative data • ‘Empirical’ or ‘conceptual’ data • Most concepts pre-specified or most concepts emergent • Relatively homogeneous or heterogeneous data • Numerical, narrative analysis or quantification of qualitative data in synthesis • Integrative or interpretative synthesis of data

  11. Systematic review questions • Questions of influence: What is the cause? • Example: • What are the underlying causes of drug related preventable hospital admissions (Slavenberg et al 2005)

  12. What are the underlying causes of drug related preventable hospital admissions?

  13. What are the underlying causes of drug related preventable hospital admissions? Statistical meta analysis • A priori or iterative procedures of review • Numerical or narrative data • ‘Empirical’ or ‘conceptual’ data • Most concepts pre-specified or most concepts emergent • Relatively homogeneous or heterogeneous data • Numerical, narrative analysis or quantification of qualitative data in synthesis • Integrative or interpretative synthesis of data

  14. Systematic review questions • Questions about structures and processes How do concepts fit together structurally and procedurally? Example: Why [are] people physically restrained in the acute and residential care settings? (Evans and FitzGerald 2002)

  15. Why [are] people physically restrained in the acute and residential care settings?

  16. Why [are] people physically restrained in the acute and residential care settings? Content analysis • A priori or iterative procedures of review • Numerical or narrative data • ‘Empirical’ or‘conceptual’ data • Structures and processes pre-specified or other concepts emergent • Relatively homogeneous or heterogeneous data • Numerical, narrative analysis or quantification of qualitative data in synthesis • Integrative or interpretative synthesis of data

  17. Systematic review questions • Questions about structures and processesWhat structures and processes (services) are needed? Example: What human service needs assessments have been conducted in Nebraska since 1990? (Gaber, 2000)

  18. What human service needs assessments have been conducted in Nebraska since 1990?

  19. What human service needs assessments have been conducted in Nebraska since 1990? Content analysis • A priori or iterative procedures of review • Numerical or narrative data • ‘Empirical’ or ‘conceptual’ data • Most concepts pre-specified or most concepts emergent • Relatively homogeneous or heterogeneous data • Numerical, narrative analysis or quantification of qualitative data in synthesis • Integrative or interpretative synthesis of data

  20. Question-led synthesis

  21. Question-led synthesis

  22. Question-led synthesis

  23. Question-led synthesis

  24. Question-led synthesis

  25. Mixed methods of synthesis • Multiple questions: impact and process; impact and agency; cause and agency • Included studies have diverse designs • Different reviews use different synthesis methods • Boolean, content analysis, thematic analysis, Bayesian analysis • Single reviews have multiple synthesis methods • Thematic analysis and statistical meta-analysis

  26. Conclusions • Reviews addressing different questions (impact, cause, process, agency) have employed different methods • Reviews addressing agency have employed ‘qualitative’ methods • Reviews addressing influence have employed ‘quantitative’ methods • Reviews addressing structures and processes have employed mixed methods • What justifies choice of synthesis methods?

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