When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
Abstract Background Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective m...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Medical Research Methodology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12874-020-01132-6 |
| _version_ | 1831688856073666560 |
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| author | A. Movsisyan E. Rehfuess S. L. Norris |
| author_facet | A. Movsisyan E. Rehfuess S. L. Norris |
| author_sort | A. Movsisyan |
| collection | DOAJ |
| description | Abstract Background Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be adopted in guideline development to facilitate a more nuanced consideration of a range of factors pertinent to decisions regarding public health and health system interventions. These factors include acceptability and feasibility, and societal, economic, and equity and equality implications of interventions. Main message A 5-step process describes how to incorporate a complexity perspective in guideline development with examples to illustrate each step. The steps include: (i) guideline scoping, (ii) formulating questions, (iii) retrieving and synthesising evidence, (iv) assessing the evidence, and (v) developing recommendations. Guideline scoping using stakeholder consultations, complexity features, evidence mapping, logic modelling, and explicit decision criteria is emphasised as a key step that informs all subsequent steps. Conclusions Through explicit consideration of a range of factors and enhanced understanding of the specific circumstances in which interventions work, a complexity perspective can yield guidelines with better informed recommendations and facilitate local adaptation and implementation. Further work will need to look into the methods of collecting and assessing different types of evidence beyond effectiveness and develop procedural guidance for prioritising across a range of decision criteria. |
| first_indexed | 2024-12-20T10:36:07Z |
| format | Article |
| id | doaj.art-d5be690161a146e1a0f2b7702964fb1f |
| institution | Directory Open Access Journal |
| issn | 1471-2288 |
| language | English |
| last_indexed | 2024-12-20T10:36:07Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Research Methodology |
| spelling | doaj.art-d5be690161a146e1a0f2b7702964fb1f2022-12-21T19:43:37ZengBMCBMC Medical Research Methodology1471-22882020-10-0120111310.1186/s12874-020-01132-6When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventionsA. Movsisyan0E. Rehfuess1S. L. Norris2Institute for Medical Information Processing, Biometry and Epidemiology, LMU MunichInstitute for Medical Information Processing, Biometry and Epidemiology, LMU MunichScience Division, Department of Quality Assurance of Norms and Standards, World Health OrganizationAbstract Background Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be adopted in guideline development to facilitate a more nuanced consideration of a range of factors pertinent to decisions regarding public health and health system interventions. These factors include acceptability and feasibility, and societal, economic, and equity and equality implications of interventions. Main message A 5-step process describes how to incorporate a complexity perspective in guideline development with examples to illustrate each step. The steps include: (i) guideline scoping, (ii) formulating questions, (iii) retrieving and synthesising evidence, (iv) assessing the evidence, and (v) developing recommendations. Guideline scoping using stakeholder consultations, complexity features, evidence mapping, logic modelling, and explicit decision criteria is emphasised as a key step that informs all subsequent steps. Conclusions Through explicit consideration of a range of factors and enhanced understanding of the specific circumstances in which interventions work, a complexity perspective can yield guidelines with better informed recommendations and facilitate local adaptation and implementation. Further work will need to look into the methods of collecting and assessing different types of evidence beyond effectiveness and develop procedural guidance for prioritising across a range of decision criteria.http://link.springer.com/article/10.1186/s12874-020-01132-6GuidelineRecommendationSystematic reviewsComplexity perspectiveSystems thinkingLogic model |
| spellingShingle | A. Movsisyan E. Rehfuess S. L. Norris When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions BMC Medical Research Methodology Guideline Recommendation Systematic reviews Complexity perspective Systems thinking Logic model |
| title | When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions |
| title_full | When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions |
| title_fullStr | When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions |
| title_full_unstemmed | When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions |
| title_short | When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions |
| title_sort | when complexity matters a step by step guide to incorporating a complexity perspective in guideline development for public health and health system interventions |
| topic | Guideline Recommendation Systematic reviews Complexity perspective Systems thinking Logic model |
| url | http://link.springer.com/article/10.1186/s12874-020-01132-6 |
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