Taking account of context in systematic reviews and guidelines considering a complexity perspective

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  • Andrew Booth
    University of Sheffield
  • Graham Moore
    Cardiff University
  • Kate Flemming
    University of York
  • Ruth Garside
    University of Exeter Medical School
  • Nigel Rollins
    Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Genève, Switzerland.
  • Özge Tunçalp
    World Health Organization, Geneva
  • Jane Noyes
    School of Social Sciences, Bangor University

Systematic review teams and guideline development groups face considerable challenges when considering context within the evidence production process. Many complex interventions are context-dependent and are frequently evaluated within considerable contextual variation and change. This paper considers the extent to which current tools used within systematic reviews and guideline development are suitable in meeting these challenges. The paper briefly reviews strengths and weaknesses of existing approaches to specifying context. Illustrative tools are mapped to corresponding stages of the systematic review process. Collectively, systematic review and guideline production reveals a rich diversity of frameworks and tools for handling context. However, current approaches address only specific elements of context, are derived from primary studies which lack information or have not been tested within systematic reviews. A hypothetical example is used to illustrate how context could be integrated throughout the guideline development process. Guideline developers and evidence synthesis organisations should select an appropriate level of contextual detail for their specific guideline that is parsimonious and yet sensitive to health systems contexts and the values, preferences and needs of their target populations.

Original languageEnglish
Pages (from-to)e000840
JournalBMJ Global Health
Volume4
Issue numberSuppl 1
DOIs
Publication statusPublished - 25 Jan 2019
Externally publishedYes
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