A typology of questions for systematic reviews on complex interventions

Article type
Authors
Hannes K1
1Cochrane Qualitative and Implementation Methods Group, Belgium
Abstract
Background:
Several authors have pleaded for the careful planning of mixed method reviews. However, the focus on the procedural or design related aspects of conducting a mixed method review leaves potential review authors with the impression that differences between quantitative and qualitative approaches to synthesizing research evidence are merely technical. Decisions about how to approach complex interventions reviews should be guided by the type of questions that emerge during the review process.

Objectives:
To present a typology of questions assisting review authors in selecting appropriate review questions for different phases in a mixed method review.

Methods:
A research inquiry into the most beneficial promotion program to stimulate breast feeding will be used as an example to illustrate how questions related to effectiveness, feasibility, appropriateness and/or meaning may reveal themselves to an author team in the context of a review on complex interventions.

Results:
Complex intervention reviews are contingent in nature and tend to move from one particular phase in a review to another. Different research questions may be generated in different phases in the iteration process. Consequently, review authors’ decisions 1) tend to grow organically, and 2) are influenced by different beliefs about what needs to be covered in a review. A phenomenon under review may appear the same across quantitative and qualitative evidence syntheses strands. However, the distinction between inquiries into ‘meaning’ and ‘effectiveness’ reconciles a phenomenon to an exclusive quantitative or qualitative research paradigm.

Conclusions:
With an emphasis on ‘phases’ in the process of a review of complex interventions we move away from a procedural focus on ‘mixing’ evidence synthesis approaches. We encourage review authors to consider which configurations of methods, techniques and approaches make sense to answer predefined, as well as emerging, research questions during the review process.