Can We Systematically Review Studies That Evaluate Complex Interventions 英文参考文献.docVIP

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Can We Systematically Review Studies That Evaluate Complex Interventions 英文参考文献.doc

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Can We Systematically Review Studies That Evaluate Complex Interventions 英文参考文献

ThePLoSMedicineDebate 1 CanWeSystematicallyReviewStudiesThatEvaluate ComplexInterventions? SashaShepperd1*,SimonLewin2,3,SharonStraus4,MikeClarke5,6,MartinP.Eccles7,RayFitzpatrick1, GeoffWong8*,AzizSheikh9,10* 1DepartmentofPublicHealth,UniversityofOxford,Oxford,UnitedKingdom,2NorwegianKnowledgeCentrefortheHealthServices,Oslo,Norway,3HealthSystems ResearchUnit,MedicalResearchCouncilofSouthAfrica,SouthAfrica,4DepartmentofMedicine,UniversityofToronto,Toronto,Ontario,Canada,5UKCochraneCentre, Oxford,UnitedKingdom,6SchoolofNursingandMidwifery,TrinityCollegeDublin,IrelandNationalInstituteforHealthResearch,Oxford,UnitedKingdom,7Instituteof HealthandSociety,NewcastleUniversity,NewcastleUponTyne,UnitedKingdom,8ResearchDepartmentofPrimaryCareandPopulationHealth,UCL,London,United Kingdom,9CentreforPopulationHealthSciences,UniversityofEdinburgh,Edinburgh,UnitedKingdom,10CAPHRI,UniversityofMaastricht,Maastricht,TheNetherlands theimplicationsoftheselimitationsandsuggestsomeapproaches to help systematic reviewers reflect on the conceptual and analyticalchallengesposedbythesetypesofreview. Background to the debate: The UK Medical Research Council defines complex interventions as those com- prising ‘‘a number of separate elements which seem essentialtotheproperfunctioningoftheinterventions althoughthe‘activeingredient’oftheinterventionthat iseffectiveisdifficult tospecify.’’ Atypicalexampleis specialist care on a stroke unit, which involves a wide range of health professionals delivering a variety of 1.DefiningtheComplexIntervention Tovaryingdegrees,complexinterventionscanbestandardised anddefinedinindividualprospectivestudies.However,thelackof anagreeddefinitionofcomplexinterventionsthathavethesame treatments. Michelle Campbell and colleagues have argued that there are ‘‘specific difficulties in defining, developing, documenting, and reproducing complex interventionsthataresubjecttomorevariationthana drug’’[10].Thesedifficultiesareoneofthereasonswhy itischallengingforresearcher