Using systems perspectives in evidence synthesis: A methodological mapping review

Abstract

Reviewing complex interventions is challenging because they include many elements that can interact dynamically in a nonlinear manner. A systems perspective offers a way of thinking to help understand complex issues, but its application in evidence synthesis is not established. The aim of this project was to understand how and why systems perspectives have been applied in evidence synthesis. A methodological mapping review was conducted to identify papers using a systems perspective in evidence synthesis. A search was conducted in seven bibliographic databases and three search engines. A total of 101 papers (representing 98 reviews) met the eligibility criteria. Two categories of reviews were identified: (1) reviews using a "systems lens" to frame the topic, generate hypotheses, select studies, and guide the analysis and interpretation of findings (n = 76) and (2) reviews using systems methods to develop a systems model (n = 22). Several methods (e.g., systems dynamic modeling, soft systems approach) were identified, and they were used to identify, rank and select elements, analyze interactions, develop models, and forecast needs. The main reasons for using a systems perspective were to address complexity, view the problem as a whole, and understand the interrelationships between the elements. Several challenges for capturing the true nature and complexity of a problem were raised when performing these methods. This review is a useful starting point when designing evidence synthesis of complex interventions. It identifies different opportunities for applying a systems perspective in evidence synthesis, and highlights both commonplace and less familiar methods.

Maintaining independence in older adults

“…This may in part be due to the focus on individual level interventions that are more likely to benefit motivated, educated, and well resourced people compared with marginalised people and socioeconomically disadvantaged populations. Expanding the synthesis to incorporate the interaction of multiple levels of action within a system, including community level and policy level interventions, as well as the effects of context, setting, and underlying mechanisms of action, would be particularly insightful for evaluating how these interventions can benefit the most vulnerable populations and reduce gaps in health equity 1213…”

Abandono y permanencia estudiantil en universidades de Latinoamérica y el Caribe: Una revisión sistemática mixta

“…Este marco epistemológico permite realizar una comprensión sistémica, interdependiente, integrada, dinámica e interdisciplinaria de dicha problemática. Lo cual permite superar enfoques multidisciplinarios tendientes a abordar la realidad de una forma fragmentada (Hong et al, 2022). A la vez que ofrece una alternativa para comprender dicho problema desde una concepción inclusiva, pluralista y participativa en la construcción del conocimiento (Hammond, 2017).…”

“…Asimismo, se plantea un nuevo modelo integrador de evidencia basado en aportes de la perspectiva sistémica (Hong et al, 2022). Este modelo permite avanzar hacia una comprensión más integrada del abandono y la permanencia articulando diversas tradiciones de investigación disciplinaria y metodologías de investigación, lo que permite superar enfoques tendientes a la fragmentación de dicha problemática.…”

Ann Oakley: new learning and global influence from working across conventional boundaries

“…Maximising the relevance of reviews to policy problems and evidence needs came from review teams and potential review users engaging with each other to understand issues from different standpoints, challenging each other, and tackling technical and political constraints to shape review questions and the analysis, and then to interpret the findings (Oliver et al, 2018a). Addressing policymakers' interests in complex systems and their complex pathways between intervention and outcome continues to drive methodological innovation (Hong et al, 2021;Kneale et al, 2018Kneale et al, , 2020. This is particularly so for resource-poor settings where challenges prompted government commissioning of the Centre for Excellence in Development Learning and Impact (CEDIL), where David Gough, as director of the EPPI-Centre, brought his experience of synthesis and studying use of research for policy decisions to his role on the steering group.…”