Use of framework synthesis to prioritise systematic review topics among multiple stakeholders: a descriptive case study

Article type
Authors
Brunton G1, Llewellyn A2, Sutcliffe K1, Rees R1, Oliver S1, Caird J1, Stokes G1, Thomas J1
1EPPI-Centre, UCL IOE London, United Kingdom
2Centre for Reviews & Dissemination, University of York, United Kingdom
Abstract
Background: Systematic reviewers are challenged to mediate between an increasing amount of research and stakeholder priorities about the most important synthesis topics. Framework synthesis offers an innovative method to meet both needs.
Objectives: To describe and reflect on framework synthesis as both a method of research synthesis and to scope and set research priorities for policy decisions, using a recent systematic review of extrahepatic conditions in hepatitis C.
Methods: To familiarise researchers with the review topic, scoping searches were undertaken and an a priori framework of extrahepatic conditions selected. An information scientist searched for quantitative studies examining associations between hepatitis C and any extrahepatic condition. Included studies were indexed/coded into the framework (i.e. coded) by their main extrahepatic condition and any newly identified conditions added. Two reviewers screened and coded reports, establishing inter-rater reliability, then undertook lone assessments. To chart the data, results were ordered by publication frequency and presented to public advocacy groups and researchers, whose prioritised extrahepatic conditions were compared and added to the framework. To interpret the findings, topics most frequently reported and also identified by all advocacy groups were prioritised for further synthesis.
Results: Searches identified 194 extrahepatic conditions. Framework synthesis structured stakeholder discussions to prioritise extrahepatic conditions and identified disparities between most frequently researched conditions and those identified as important by people experiencing the conditions. Differences in presentation of the framework during consultations may have influenced which topics each group prioritised.
Conclusions: Framework synthesis integrated different perspectives, facilitating transparent research decisions. Use of an a priori framework enabled coding within short timelines. The differing roles and priorities of consulted stakeholders suggest that equal involvement is more likely, and response bias reduced, if all stakeholder groups are given consistent information.