Rockers Peter C, Tugwell Peter, Grimshaw Jeremy, Oliver Sandy, Atun Rifat, Røttingen John-Arne, Fretheim Atle, Ranson M Kent, Daniels Karen, Luiza Vera Lucia, Bärnighausen Till
Department of Global Health, Boston University School of Public Health, 801 Massachusetts Avenue, Room 384, Boston, MA, USA.
Department of Medicine, University of Ottawa, 43 Bruyère St, Ottawa, Ontario, Canada K1N 5C7.
J Clin Epidemiol. 2017 Sep;89:98-105. doi: 10.1016/j.jclinepi.2016.03.034. Epub 2017 Mar 28.
Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews.
尽管准实验研究在设计良好时能够提供有力的因果证据，但来自这类研究的证据在卫生系统研究的系统评价中往往被排除在外。本文探讨了为将准实验的因果证据纳入卫生系统研究的系统评价而进行制度化的全球协调努力。具体而言，我们关注的是在全球和地方层面寻找机会，加强实施必要方案的能力，以确保纳入准实验的评价始终保持最高质量。我们首先描述了促进卫生系统研究系统评价产生的全球基础设施的现状。我们确定了在这一基础设施内运作的五种重要类型的行为主体：评价作者；促进评价过程的综合协作；补充大型协作工作的综合利益集团；评价资助者；以及包括政策制定者在内的最终用户。然后，我们研究了进行干预以建设各类行为主体的能力，以支持在评价中纳入准实验的机会。最后，我们提出了推进能力建设工作的切实可行的下一步措施。鉴于该领域的复杂性和相对新生性，我们建议采取精心规划和执行的方法，加强在系统评价中纳入准实验研究的全球能力。
