Norwegian Institute of Public Health, Oslo, Norway.
Syst Rev. 2019 Jan 14;8(1):22. doi: 10.1186/s13643-018-0893-4.
Systematic reviews of research evidence have become an expected basis for decisions about practice guidelines and policy decisions in the health and welfare sectors. Review authors define inclusion criteria to help them determine which studies to search for and include in their reviews. However, these studies may still vary in the extent to which they reflect the context of interest in the review question. While most review authors would agree that systematic reviews should be relevant and useful for decision makers, there appears to be few well known, if any, established methods for supporting review authors to assess the transferability of review findings to the context of interest in the review. With this systematic mapping and content analysis, we aim to identify whether there exists checklists to support review authors in considering transferability early in the systematic review process. The secondary aim was to develop a comprehensive list of factors that influence transferability as discussed in existing checklists.
We conducted a systematic mapping of checklists and performed a content analysis of the checklist criteria included in the identified checklists. In June 2016, we conducted a systematic search of eight databases to identify checklists to assess transferability of findings from primary or secondary research, without limitations related to publication type, status, language, or date. We also conducted a gray literature search and searched the EQUATOR repository of checklists for any relevant document. We used search terms such as modified versions of the terms "transferability," "applicability," "generalizability," etc. and "checklist," "guideline," "tool," "criteria," etc. We did not include papers that discussed transferability at a theoretical level or checklists to assess the transferability of guidelines to local contexts.
Our search resulted in 11,752 titles which were screened independently by two review authors. The 101 articles which were considered potentially relevant were subsequently read by two authors, independently in full text and assessed for inclusion. We identified 31 relevant checklists. Six of these examined transferability of economic evaluations, and 25 examined transferability of primary or secondary research findings in health (n = 23) or social welfare (n = 2). The content analysis is based on the 25 health and social welfare checklists. We identified seven themes under which we grouped categories of checklist criteria: population, intervention, implementation context (immediate), comparison intervention, outcomes, environmental context, and researcher conduct.
We identified a variety of checklists intended to support end users (researchers, review authors, practitioners, etc.) to assess transferability or related concepts. While four of these checklists are intended for use in systematic reviews of effectiveness, we found no checklists for qualitative evidence syntheses or for the field of social welfare practice or policy. Furthermore, none of the identified checklists for review authors included guidance to on how to assess transferability, or present assessments in a systematic review. The results of the content analysis can serve as the basis for developing a comprehensive list of factors to be used in an approach to support review authors in systematically and transparently considering transferability from the beginning of the review process.
系统评价研究证据已成为医疗保健和福利部门制定实践指南和政策决策的预期依据。综述作者定义纳入标准,以帮助他们确定要搜索和纳入综述的研究。然而,这些研究在多大程度上反映了综述问题的背景方面可能存在差异。虽然大多数综述作者都认为系统评价应该对决策者具有相关性和有用性,但似乎很少有知名的(如果有的话)既定方法来支持综述作者评估研究结果对综述中感兴趣的背景的可转移性。通过这项系统的制图和内容分析,我们旨在确定是否存在检查表来支持综述作者在系统评价过程的早期阶段考虑可转移性。次要目的是制定一份全面的影响可转移性因素清单,这些因素在现有的检查表中进行了讨论。
我们对检查表进行了系统的制图,并对确定的检查表中的检查表标准进行了内容分析。2016 年 6 月,我们对八个数据库进行了系统搜索,以确定评估初级或二级研究结果可转移性的检查表,不受与出版类型、状态、语言或日期相关的限制。我们还进行了灰色文献搜索,并在 EQUATOR 检查表库中搜索了任何相关文件。我们使用了“可转移性”、“适用性”、“可推广性”等术语的修改版本,以及“检查表”、“指南”、“工具”、“标准”等术语。我们不包括仅在理论层面上讨论可转移性的论文或评估指南在当地背景下的可转移性的检查表。
我们的搜索结果产生了 11752 个标题,由两名综述作者独立筛选。考虑到可能相关的 101 篇文章随后由两名作者独立全文阅读并评估是否纳入。我们确定了 31 份相关检查表。其中 6 份检查了经济评估的可转移性,25 份检查了健康(n=23)或社会福利(n=2)领域的初级或二级研究结果的可转移性。内容分析基于 25 份健康和社会福利检查表。我们确定了七个主题,我们将这些主题分为检查表标准的类别:人群、干预、实施环境(直接)、比较干预、结果、环境背景和研究人员行为。
我们确定了各种检查表,旨在支持最终用户(研究人员、综述作者、从业者等)评估可转移性或相关概念。其中四份检查表用于评估有效性的系统评价,我们没有找到定性证据综合或社会福利实践或政策领域的检查表。此外,没有一份为综述作者准备的检查表包括评估可转移性的指导,或者在系统评价中呈现评估结果。内容分析的结果可以作为开发一套全面的因素清单的基础,用于支持综述作者在从审查过程开始就系统地和透明地考虑可转移性。