Centre for Advancement in Realist Evaluation and Synthesis (CARES; http://www.realistmethodology-cares.org ); and Institute of Population Health Sciences, University of Liverpool, Liverpool L69 3GL, United Kingdom; email:
Annu Rev Public Health. 2019 Apr 1;40:361-372. doi: 10.1146/annurev-publhealth-031816-044451. Epub 2019 Jan 11.
Realist synthesis is a literature review methodology for understanding how, for whom, and under what circumstances complex interventions function in complex environments. Using a heuristic called the context-mechanism-outcome (CMO) configuration, realist synthesis produces evidence-informed theories about the interactions between intervention mechanisms and their implementation contexts. Public health interventions and their effects unfold over time and develop differently in different contexts. Much of what causes programs to function remains in a realm beyond empirical measurement. By scrutinizing the theories relevant to the interventions of interest, and by enhancing the conceptualization of complex outcomes, the realist approach deprioritizes evidence hierarchies and harnesses insights from diverse data sources to generate causal understanding. The dynamic learning process that can arise in conducting a realist synthesis may generate new ideas for program development and innovation apart from what can be achieved in reviews providing a summation and aggregation of quantified evidence.
现实主义综合是一种文献综述方法，用于了解复杂干预措施在复杂环境中如何、为谁以及在什么情况下发挥作用。现实主义综合使用一种称为“情境-机制-结果（CMO）配置”的启发式方法，生成关于干预机制及其实施情境之间相互作用的循证理论。公共卫生干预措施及其效果随着时间的推移而展开，并在不同的情境中以不同的方式发展。导致项目发挥作用的大部分原因仍处于经验测量之外。通过仔细审查与感兴趣的干预措施相关的理论，并增强对复杂结果的概念化，现实主义方法降低了证据层次结构的优先级，并利用来自不同数据源的见解来产生因果理解。在进行现实主义综合时可能会出现的动态学习过程可能会产生新的项目开发和创新思路，而不仅仅是提供量化证据的总结和汇总的综述所能实现的思路。
