Article type
Year
Abstract
Background: Reviewing complex interventions is challenging because they include a large number of elements that can interact dynamically in a non-linear manner. Also, complex interventions are often nested within a wider system that cannot be fully understood by only using linear causal models and by examining their components in isolation. To address this complexity, it has been advocated to use systems perspectives in systematic reviews. However, it is not clear to what extent systems perspectives provide different analytical possibilities and how to apply them in systematic reviews.
Objective: To explore how systems perspectives have been applied in systematic reviews.
Methods: A mapping review was performed. Seven databases were searched (May 2019): Medline, Embase, PsycINFO, CINAHL, Social Sciences Citation Index, Public Health Database, and ABI/INFORM. The search strategy combined key terms on ‘systems perspectives’ and ‘systematic reviews’. The search was supplemented by focussed searching of three online search engines: Google Scholar, Microsoft Academic, and BASE (Bielefeld Academic Search Engine). Two reviewers independently screened 5% of the records to clarify the selection criteria, and one reviewer screening the remaining records. Descriptive synthesis served to summarize the reviews characteristics (year, country, topic) and data on systems perspectives (framework, systems methods, software, and systems results). Data on the reasons for using systems perspectives and challenges encountered when using systems perspective were categorized.
Results: A total of 3028 records were screened, 436 full-text papers were assessed for eligibility, and 112 papers (representing 111 reviews) were retained. In general, two categories of papers were identified. First, several reviews mentioned using ‘systems lens’ (n=86). A systems framework or theory (e.g., Bronfenbrenner’s ecological systems theory, von Bertalanffy’s general system theory) was used to frame the topic, generate hypotheses, guide the selection of studies, structure the analysis of the literature and/or interpret the results of the review. Second, a smaller number of reviews (n=25) used systems methods to analyse the findings from included studies (e.g., systems dynamic modelling, soft systems approach) and/or developed systems models (e.g., causal loop diagrams, systems maps).
Conclusions: This review found examples of application of systems perspectives in reviews. Using systems perspectives offer a holistic way of thinking to better understand complex interventions. They allow for a deeper and broader understanding of the interrelationships, synergies, and feedback-loop interactions between elements within the boundary of a system. These approaches can enhance the relevance of findings from systematic reviews by facilitating understanding of complex situations and producing useful information for patients, stakeholders and decision makers.
Objective: To explore how systems perspectives have been applied in systematic reviews.
Methods: A mapping review was performed. Seven databases were searched (May 2019): Medline, Embase, PsycINFO, CINAHL, Social Sciences Citation Index, Public Health Database, and ABI/INFORM. The search strategy combined key terms on ‘systems perspectives’ and ‘systematic reviews’. The search was supplemented by focussed searching of three online search engines: Google Scholar, Microsoft Academic, and BASE (Bielefeld Academic Search Engine). Two reviewers independently screened 5% of the records to clarify the selection criteria, and one reviewer screening the remaining records. Descriptive synthesis served to summarize the reviews characteristics (year, country, topic) and data on systems perspectives (framework, systems methods, software, and systems results). Data on the reasons for using systems perspectives and challenges encountered when using systems perspective were categorized.
Results: A total of 3028 records were screened, 436 full-text papers were assessed for eligibility, and 112 papers (representing 111 reviews) were retained. In general, two categories of papers were identified. First, several reviews mentioned using ‘systems lens’ (n=86). A systems framework or theory (e.g., Bronfenbrenner’s ecological systems theory, von Bertalanffy’s general system theory) was used to frame the topic, generate hypotheses, guide the selection of studies, structure the analysis of the literature and/or interpret the results of the review. Second, a smaller number of reviews (n=25) used systems methods to analyse the findings from included studies (e.g., systems dynamic modelling, soft systems approach) and/or developed systems models (e.g., causal loop diagrams, systems maps).
Conclusions: This review found examples of application of systems perspectives in reviews. Using systems perspectives offer a holistic way of thinking to better understand complex interventions. They allow for a deeper and broader understanding of the interrelationships, synergies, and feedback-loop interactions between elements within the boundary of a system. These approaches can enhance the relevance of findings from systematic reviews by facilitating understanding of complex situations and producing useful information for patients, stakeholders and decision makers.