Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 25;4(Suppl 1):e000893.
doi: 10.1136/bmjgh-2018-000893. eCollection 2019.

Synthesising quantitative and qualitative evidence to inform guidelines on complex interventions: clarifying the purposes, designs and outlining some methods

Jane Noyes  1 , Andrew Booth  2 , Graham Moore  3 , Kate Flemming  4 , Özge Tunçalp  5 , Elham Shakibazadeh  6
Affiliations

Synthesising quantitative and qualitative evidence to inform guidelines on complex interventions: clarifying the purposes, designs and outlining some methods

Jane Noyes et al. BMJ Glob Health. .

Abstract

Guideline developers are increasingly dealing with more difficult decisions concerning whether to recommend complex interventions in complex and highly variable health systems. There is greater recognition that both quantitative and qualitative evidence can be combined in a mixed-method synthesis and that this can be helpful in understanding how complexity impacts on interventions in specific contexts. This paper aims to clarify the different purposes, review designs, questions, synthesis methods and opportunities to combine quantitative and qualitative evidence to explore the complexity of complex interventions and health systems. Three case studies of guidelines developed by WHO, which incorporated quantitative and qualitative evidence, are used to illustrate possible uses of mixed-method reviews and evidence. Additional examples of methods that can be used or may have potential for use in a guideline process are outlined. Consideration is given to the opportunities for potential integration of quantitative and qualitative evidence at different stages of the review and guideline process. Encouragement is given to guideline commissioners and developers and review authors to consider including quantitative and qualitative evidence. Recommendations are made concerning the future development of methods to better address questions in systematic reviews and guidelines that adopt a complexity perspective.

Keywords: health systems; qualitative study; randomised control trial; systematic review.

PubMed Disclaimer

Conflict of interest statement

Competing interests: No financial interests declared. JN, AB and ÖT have an intellectual interest in GRADE CERQual; and JN has an intellectual interest in the iCAT_SR tool.

References

    1. Victora CG, Habicht JP, Bryce J. Evidence-based public health: moving beyond randomized trials. Am J Public Health 2004;94:400–5. 10.2105/AJPH.94.3.400 - DOI - PMC - PubMed
    1. de Savigny D, Borghi J, Windish R. Chapter 3. Systems thinging: applying a systems perspective to design and evaluate health systems interventions. In: de Savigny D, Tagheed A, eds. Systems thinging for health systems strengtheing. Geneva: World Health Organisation, 2009.
    1. Fletcher A, Jamal F, Moore G, et al. Realist complex intervention science: applying realist principles across all phases of the Medical Research Council framework for developing and evaluating complex interventions. Evaluation 2016;22:286–303. 10.1177/1356389016652743 - DOI - PMC - PubMed
    1. Raine R, Fitzpatrick R, Barratt H, et al. Challenges, solutions and future directions in the evaluation of service innovations in health care and public health. Health Services and Delivery Research 2016;4:1–136. 10.3310/hsdr04160 - DOI
    1. Baum F. Researching public health: behind the qualitative-quantitative methodological debate. Soc Sci Med 1995;40:459–68. 10.1016/0277-9536(94)E0103-Y - DOI - PubMed

LinkOut - more resources