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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="author" content="Jeanne-Marie Guise, Christine Chang, Meera Viswanathan, Susan Glick, Jonathan Treadwell, Craig A Umscheid, Evelyn Whitlock, Rochelle Fu, Elise Berliner, Robin Paynter, Johanna Anderson, Pua Motu'apuaka, Tom Trikalinos" /><meta name="citation_title" content="Systematic Reviews of Complex Multicomponent Health Care Interventions" /><meta name="citation_publisher" content="Agency for Healthcare Research and Quality (US)" /><meta name="citation_date" content="2014/03" /><meta name="citation_author" content="Jeanne-Marie Guise" /><meta name="citation_author" content="Christine Chang" /><meta name="citation_author" content="Meera Viswanathan" /><meta name="citation_author" content="Susan Glick" /><meta name="citation_author" content="Jonathan Treadwell" /><meta name="citation_author" content="Craig A Umscheid" /><meta name="citation_author" content="Evelyn Whitlock" /><meta name="citation_author" content="Rochelle Fu" /><meta name="citation_author" content="Elise Berliner" /><meta name="citation_author" content="Robin Paynter" /><meta name="citation_author" content="Johanna Anderson" /><meta name="citation_author" content="Pua Motu'apuaka" /><meta name="citation_author" content="Tom Trikalinos" /><meta name="citation_pmid" content="24696890" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK194846/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Systematic Reviews of Complex Multicomponent Health Care Interventions" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="Agency for Healthcare Research and Quality (US)" /><meta name="DC.Contributor" content="Jeanne-Marie Guise" /><meta name="DC.Contributor" content="Christine Chang" /><meta name="DC.Contributor" content="Meera Viswanathan" /><meta name="DC.Contributor" content="Susan Glick" /><meta name="DC.Contributor" content="Jonathan Treadwell" /><meta name="DC.Contributor" content="Craig A Umscheid" /><meta name="DC.Contributor" content="Evelyn Whitlock" /><meta name="DC.Contributor" content="Rochelle Fu" /><meta name="DC.Contributor" content="Elise Berliner" /><meta name="DC.Contributor" content="Robin Paynter" /><meta name="DC.Contributor" content="Johanna Anderson" /><meta name="DC.Contributor" content="Pua Motu'apuaka" /><meta name="DC.Contributor" content="Tom Trikalinos" /><meta name="DC.Date" content="2014/03" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK194846/" /><meta name="DC.Language" content="en" /><meta name="description" content="The purpose of this report is to outline approaches to address the challenges of conducting systematic reviews of complex multicomponent health care interventions." /><meta name="og:title" content="Systematic Reviews of Complex Multicomponent Health Care Interventions" /><meta name="og:type" content="book" /><meta name="og:description" content="The purpose of this report is to outline approaches to address the challenges of conducting systematic reviews of complex multicomponent health care interventions." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK194846/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-methrescmhc-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/methrescmhc/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK194846/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="methodscollect" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/methrescmhc/fm.s1/" title="Next page in this title">Next ></a></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="https://effectivehealthcare.ahrq.gov" title="Agency for Healthcare Research and Quality (US)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-methrescmhc-lrg.png" alt="Cover of Systematic Reviews of Complex Multicomponent Health Care Interventions" /></a><div class="icnblk_cntnt"><h1 id="_NBK194846_"><span itemprop="name">Systematic Reviews of Complex Multicomponent Health Care Interventions</span></h1><p><i>Research White Papers</i></p><p class="contrib-group">Investigators: <span itemprop="author">Jeanne-Marie Guise</span>, MD, MPH, <span itemprop="author">Christine Chang</span>, MD, MPH, <span itemprop="author">Meera Viswanathan</span>, PhD, <span itemprop="author">Susan Glick</span>, MD, <span itemprop="author">Jonathan Treadwell</span>, PhD, <span itemprop="author">Craig A Umscheid</span>, MD, MSCE, <span itemprop="author">Evelyn Whitlock</span>, MD, MPH, <span itemprop="author">Rochelle Fu</span>, PhD, <span itemprop="author">Elise Berliner</span>, PhD, <span itemprop="author">Robin Paynter</span>, MLS, <span itemprop="author">Johanna Anderson</span>, MPH, <span itemprop="author">Pua Motu'apuaka</span>, BS, and <span itemprop="author">Tom Trikalinos</span>, PhD.</p><a data-jig="ncbitoggler" href="#__NBK194846_ai__" style="border:0;text-decoration:none">Author Information and Affiliations</a><div style="display:none" class="ui-widget" id="__NBK194846_ai__"><p class="contrib-group"><h4>Authors</h4>Investigators: <span itemprop="author">Jeanne-Marie Guise</span>, MD, MPH, <span itemprop="author">Christine Chang</span>, MD, MPH, <span itemprop="author">Meera Viswanathan</span>, PhD, <span itemprop="author">Susan Glick</span>, MD, <span itemprop="author">Jonathan Treadwell</span>, PhD, <span itemprop="author">Craig A Umscheid</span>, MD, MSCE, <span itemprop="author">Evelyn Whitlock</span>, MD, MPH, <span itemprop="author">Rochelle Fu</span>, PhD, <span itemprop="author">Elise Berliner</span>, PhD, <span itemprop="author">Robin Paynter</span>, MLS, <span itemprop="author">Johanna Anderson</span>, MPH, <span itemprop="author">Pua Motu'apuaka</span>, BS, and <span itemprop="author">Tom Trikalinos</span>, PhD.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> Scientific Resource Center</div></div><div class="half_rhythm">Rockville (MD): <a href="https://effectivehealthcare.ahrq.gov" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">Agency for Healthcare Research and Quality (US)</span></a>; <span itemprop="datePublished">2014 Mar</span>.<div class="small">Report No.: 14-EHC003-EF</div></div><div class="half_rhythm"><ul class="inline_list"><li><span class="label"><a data-jig="ncbidialog" href="#_ncbi_dlg_cpyrght_NBK194846" data-jigconfig="modal:true">Copyright and
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For more information, see the <a href="/books/about/copyright/">Bookshelf Copyright Notice</a>.</div></div><div class="bk_noprnt"><form method="get" action="/books/n/methrescmhc/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Structured Abstract</h2><div id="objective"><h4 class="inline">Objective:</h4><p>The purpose of this report is to outline approaches to address the challenges of conducting systematic reviews of complex multicomponent health care interventions.</p></div><div id="method"><h4 class="inline">Methods:</h4><p>We performed a literature scan and conducted semi-structured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions, or organizational leaders who implement complex multicomponent interventions in health care.</p></div><div id="result"><h4 class="inline">Results:</h4><p>Challenges identified include: a lack of consistent terminology for such interventions (e.g., complex; multicomponent; multidimensional; multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from more holistic to individual component analytic approaches; and incomplete and inconsistent reporting in primary and secondary studies of those elements critical to understanding the success and impact of such interventions, such as the methods used to implement the intervention, and the context in which it is implemented.</p></div><div id="conclusions"><h4 class="inline">Conclusions:</h4><p>We provided a framework to understand the spectrum of conceptual and analytic approaches and an initial list of critical reporting elements for primary and secondary studies of multicomponent interventions. This information will help reviewers understand the options and tradeoffs available for such reviews.</p></div></div><div><h2>Contents</h2><div class="bktoc_all_cntnr top align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div><ul id="toc_tllNBK194846_fm_s1" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK194846_fm_s1"><a href="/books/n/methrescmhc/fm.s1/" class="toc-item">Preface</a></li><li class="half_rhythm" id="toc_itm_NBK194846_background"><a href="/books/n/methrescmhc/background/" class="toc-item">Background</a></li><li class="half_rhythm" id="toc_itm_NBK194846_methods"><a href="/books/n/methrescmhc/methods/" class="toc-item">Methods</a><ul id="toc_lst_NBK194846_methods_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK194846_methods_s1"><a href="/books/n/methrescmhc/methods/#methods.s1" class="toc-item">Overview of the Approach</a></li><li class="half_rhythm" id="toc_itm_NBK194846_methods_s2"><a href="/books/n/methrescmhc/methods/#methods.s2" class="toc-item">Literature Summary</a></li><li class="half_rhythm" id="toc_itm_NBK194846_methods_s3"><a href="/books/n/methrescmhc/methods/#methods.s3" class="toc-item">Key Informant Interviews</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK194846_results"><a href="/books/n/methrescmhc/results/" class="toc-item">Results</a><ul id="toc_lst_NBK194846_results_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK194846_results_s1"><a href="/books/n/methrescmhc/results/#results.s1" class="toc-item">Overview</a></li><li class="half_rhythm" id="toc_itm_NBK194846_results_s2"><a href="/books/n/methrescmhc/results/#results.s2" class="toc-item">Terminology</a></li><li class="half_rhythm" id="toc_itm_NBK194846_results_s6"><a href="/books/n/methrescmhc/results/#results.s6" class="toc-item">Framing the Review</a></li><li class="half_rhythm" id="toc_itm_NBK194846_results_s23"><a href="/books/n/methrescmhc/results/#results.s23" class="toc-item">Literature Search for Reviews</a></li><li class="half_rhythm" id="toc_itm_NBK194846_results_s40"><a href="/books/n/methrescmhc/results/#results.s40" class="toc-item">Study Designs Included in Reviews</a></li><li class="half_rhythm" id="toc_itm_NBK194846_results_s41"><a href="/books/n/methrescmhc/results/#results.s41" class="toc-item">Analytic Considerations</a></li><li class="half_rhythm" id="toc_itm_NBK194846_results_s37"><a href="/books/n/methrescmhc/results/#results.s37" class="toc-item">Reporting Elements</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK194846_discussion"><a href="/books/n/methrescmhc/discussion/" class="toc-item">Discussion</a><ul id="toc_lst_NBK194846_discussion_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK194846_discussion_s1"><a href="/books/n/methrescmhc/discussion/#discussion.s1" class="toc-item">Next Steps</a></li><li class="half_rhythm" id="toc_itm_NBK194846_discussion_s2"><a href="/books/n/methrescmhc/discussion/#discussion.s2" class="toc-item">Conclusions</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK194846_references_rl1"><a href="/books/n/methrescmhc/references.rl1/" class="toc-item">References</a></li><li class="half_rhythm" id="toc_itm_NBK194846_appa"><a href="/books/n/methrescmhc/appa/" class="toc-item">Appendix A Search Strategy</a></li><li class="half_rhythm" id="toc_itm_NBK194846_appb"><a href="/books/n/methrescmhc/appb/" class="toc-item">Appendix B Key Informants</a></li><li class="half_rhythm" id="toc_itm_NBK194846_appc"><a href="/books/n/methrescmhc/appc/" class="toc-item">Appendix C Selected Quotes From Interviews</a></li><li class="half_rhythm" id="toc_itm_NBK194846_appd"><a href="/books/n/methrescmhc/appd/" class="toc-item">Appendix D Analytic Models and Description of Synthesis Options</a></li></ul><div class="bktoc_all_cntnr align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div></div><div><p><b>Prepared for:</b>
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Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services<a class="bk_pop" href="#address1"><sup>1</sup></a>,
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<b>Contract No.</b>
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290-2012-00004-C. <b>Prepared by:</b>
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Scientific Resource Center, Portland, OR</p></div><div><h4 class="inline">Suggested citation:</h4><p>Guise JM, Chang C, Viswanathan M, Glick S, Treadwell J, Umscheid C, Whitlock E, Fu R, Berliner E, Paynter R, Anderson J, Motu'apuaka M, Trikalinos T. Systematic Reviews of Complex Multicomponent Health Care Interventions. Research White Paper. AHRQ Publication No. 14-EHC003-EF. Rockville, MD: Agency for Healthcare Research and Quality. March 2014. <a href="http://www.effectivehealthcare.ahrq.gov/reports/final.cfm" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.effectivehealthcare.ahrq.gov/reports/final.cfm</a>.</p></div><div><p>This report is based on research conducted by the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Centers' Methods Working Group. The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.</p><p>The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information (i.e., in the context of available resources and circumstances presented by individual patients).</p><p>This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.</p><p>None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.</p></div><div><dl class="temp-labeled-list small"><dt>1</dt><dd><div id="address1"><p class="no_top_margin">540 Gaither Road, Rockville, MD 20850; <a href="http://www.ahrq.gov" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www<wbr style="display:inline-block"></wbr>.ahrq.gov</a></p></div></dd></dl></div></div></div>
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