评估系统评价中干预措施的复杂性：一种新工具（iCAT_SR）的开发、内容及应用
Assessing the complexity of interventions within systematic reviews: development, content and use of a new tool (iCAT_SR).
作者信息
Lewin Simon, Hendry Maggie, Chandler Jackie, Oxman Andrew D, Michie Susan, Shepperd Sasha, Reeves Barnaby C, Tugwell Peter, Hannes Karin, Rehfuess Eva A, Welch Vivien, Mckenzie Joanne E, Burford Belinda, Petkovic Jennifer, Anderson Laurie M, Harris Janet, Noyes Jane
机构信息
Norwegian Institute of Public Health, Oslo, Norway.
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
出版信息
BMC Med Res Methodol. 2017 Apr 26;17(1):76. doi: 10.1186/s12874-017-0349-x.
BACKGROUND
Health interventions fall along a spectrum from simple to more complex. There is wide interest in methods for reviewing 'complex interventions', but few transparent approaches for assessing intervention complexity in systematic reviews. Such assessments may assist review authors in, for example, systematically describing interventions and developing logic models. This paper describes the development and application of the intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR), a new tool to assess and categorise levels of intervention complexity in systematic reviews.
METHODS
We developed the iCAT_SR by adapting and extending an existing complexity assessment tool for randomized trials. We undertook this adaptation using a consensus approach in which possible complexity dimensions were circulated for feedback to a panel of methodologists with expertise in complex interventions and systematic reviews. Based on these inputs, we developed a draft version of the tool. We then invited a second round of feedback from the panel and a wider group of systematic reviewers. This informed further refinement of the tool.
RESULTS
The tool comprises ten dimensions: (1) the number of active components in the intervention; (2) the number of behaviours of recipients to which the intervention is directed; (3) the range and number of organizational levels targeted by the intervention; (4) the degree of tailoring intended or flexibility permitted across sites or individuals in applying or implementing the intervention; (5) the level of skill required by those delivering the intervention; (6) the level of skill required by those receiving the intervention; (7) the degree of interaction between intervention components; (8) the degree to which the effects of the intervention are context dependent; (9) the degree to which the effects of the interventions are changed by recipient or provider factors; (10) and the nature of the causal pathway between intervention and outcome. Dimensions 1-6 are considered 'core' dimensions. Dimensions 7-10 are optional and may not be useful for all interventions.
CONCLUSIONS
The iCAT_SR tool facilitates more in-depth, systematic assessment of the complexity of interventions in systematic reviews and can assist in undertaking reviews and interpreting review findings. Further testing of the tool is now needed.
背景
健康干预措施的范围从简单到复杂不等。人们对“复杂干预措施”的评价方法有着广泛的兴趣，但在系统评价中，用于评估干预措施复杂性的透明方法却很少。此类评估可能会帮助综述作者，例如，系统地描述干预措施并构建逻辑模型。本文介绍了系统评价干预复杂性评估工具（iCAT_SR）的开发与应用，这是一种用于评估和分类系统评价中干预措施复杂程度的新工具。
方法
我们通过改编和扩展现有的随机试验复杂性评估工具来开发iCAT_SR。我们采用了一种共识方法进行改编，即将可能的复杂性维度分发给一组在复杂干预措施和系统评价方面具有专业知识的方法学家，以征求他们的反馈意见。基于这些意见，我们开发了该工具的草稿版本。然后，我们邀请该小组以及更广泛的系统评价人员进行第二轮反馈。这为工具的进一步完善提供了依据。
结果
该工具包括十个维度：（1）干预措施中活性成分的数量；（2）干预措施所针对的接受者行为的数量；（3）干预措施所针对的组织层面的范围和数量；（4）在应用或实施干预措施时，预期的定制程度或允许各地点或个体的灵活性程度；（5）实施干预措施的人员所需的技能水平；（6）接受干预措施的人员所需的技能水平；（7）干预措施各成分之间的相互作用程度；（8）干预措施的效果依赖于背景的程度；（9）干预措施的效果因接受者或提供者因素而改变的程度；（10）干预措施与结果之间因果路径的性质。维度1 - 6被视为“核心”维度。维度7 - 10是可选的，可能并非对所有干预措施都有用。
结论
iCAT_SR工具有助于在系统评价中更深入、系统地评估干预措施的复杂性，并可协助进行评价和解释评价结果。现在需要对该工具进行进一步测试。
Zotero 插件