Article

How can we synthesize qualitative and quantitative evidence for healthcare policy-makers and managers?

Health Services Research, School of Nursing and Midwifery at the University of Southampton.
Healthcare management forum / Canadian College of Health Service Executives = Forum gestion des soins de santé / Collège canadien des directeurs de services de santé 02/2006; 19(1):27-31. DOI: 10.1016/S0840-4704(10)60079-8
Source: PubMed

ABSTRACT Interest in synthesizing the findings of qualitative and quantitative evidence is increasing in response to the complex questions being asked by healthcare managers and policy-makers. There is a wealth of evidence available from many sources--both formal research and non-research based (e.g., expert opinion, stakeholder, and user views). Synthesis offers the opportunity to integrate diverse forms of evidence into a whole. We categorize the current approaches to the synthesis of qualitative and quantitative evidence into four broad groups: narrative, qualitative, quantitative, and Bayesian. Many of the methods for synthesis are emergent; some have been used to integrate primary data; few have a long history of application to healthcare. In the healthcare context, synthesis methods are less well developed than methods such as systematic review. Nonetheless, synthesis has the potential to provide knowledge and decision support to healthcare policy-makers and managers.

Download full-text

Full-text

Available from: Catherine Pope, Aug 11, 2014
4 Followers
 · 
98 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence briefs have emerged as a promising approach to synthesizing the best available research evidence for health system policymakers and stakeholders. An evidence brief may draw on systematic reviews and many other types of policy-relevant information, including local data and studies, to describe a problem, options for addressing it, and key implementation considerations. We conducted a systematic review to examine the ways in which context- and issue-related factors influence the perceived usefulness of evidence briefs among their intended users. We used a critical interpretive synthesis approach to review both empirical and nonempirical literature and to develop a model that explains how context and issues influence policymakers' and stakeholders' views of the utility of evidence briefs prepared for priority policy issues. We used a "compass" question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, HealthSTAR, IPSA, MEDLINE, OAIster (gray literature), ProQuest A&I Theses, ProQuest (Sociological Abstracts, Applied Social Sciences Index and Abstracts, Worldwide Political Science Abstracts, International Bibliography of Social Sciences, PAIS, Political Science), PsychInfo, Web of Science, and WilsonWeb (Social Science Abstracts). Finally, we used a grounded and interpretive analytic approach to synthesize the results. Of the 4,461 papers retrieved, 3,908 were excluded and 553 were assessed for "relevance," with 137 included in the initial sample of papers to be analyzed and an additional 23 purposively sampled to fill conceptual gaps. Several themes emerged: (1) many established types of "evidence" are viewed as useful content in an evidence brief, along with several promising formatting features; (2) contextual factors, particularly the institutions, interests, and values of a given context, can influence views of evidence briefs; (3) whether an issue is polarizing and whether it is salient (or not) and familiar (or not) to actors in the policy arena can influence views of evidence briefs prepared for that issue; (4) influential factors can emerge in several ways (as context driven, issue driven, or a result of issue-context resonance); (5) these factors work through two primary pathways, affecting either the users or the producers of briefs; and (6) these factors influence views of evidence briefs through a variety of mechanisms. Those persons funding and preparing evidence briefs need to consider a variety of context- and issue-related factors when deciding how to make them most useful in policymaking.
    Milbank Quarterly 09/2013; 91(3):604-48. DOI:10.1111/1468-0009.12026
  • [Show abstract] [Hide abstract]
    ABSTRACT: We do not know the extent and nature of knowledge translation (KT) in oncology. This study examined colorectal cancer (CRC) health services research, and engaged researchers and decision makers in prioritizing KT research gaps. MEDLINE was searched from 1996 to 2006 for CRC health services research in Canada, Australia, the United Kingdom, and United States. Studies were tabulated by indicator, type of research and country to reveal gaps. Researchers and decision makers prioritized gaps via questionnaire, then generated research questions for top-ranked gaps at a one-day workshop. A total of 132 articles were categorized and 29 individuals attended the workshop. We lack knowledge about factors influencing rates of many indicators. Researchers and decision makers prioritized KT research on factors that could either influence the utilization of screening or enhance the quality of surgical outcomes. They acknowledged lack of research capacity and policy support as barriers, and confusion about the concept of KT. Several opportunities were revealed for improving the quality of CRC screening and surgery. Greater coordination of, and support for KT research is required to address these gaps. Further research should evaluate different methods of achieving KT between researchers and decision makers for research planning.
    Cancer Causes and Control 09/2008; 19(6):615-30. DOI:10.1007/s10552-008-9126-9
  • [Show abstract] [Hide abstract]
    ABSTRACT: Reviews offer examinations of published material on a topic, and are becoming indispensable in keeping up with an exponentially growing rehabilitation literature. Adherents of the systematic reviews that support evidence-based practice have been quite dismissive of narrative (traditional, qualitative, and nonsystematic) reviews. However, the types of problems that plague the latter may also be found in systematic reviews, which, in addition, have problems of their own. It is argued here that reviews play a number of roles in scientific research and professional practice such as answering specific clinical questions, pooling data, comparing research, synthesizing complementary studies, offering guidance in uncharted fields, and "translating" research between disciplinary traditions. For some of these purposes, systematic reviews are better; for others, a narrative review is more suitable. Both types can be improved to serve the reader better in keeping up with the literature.
    American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 06/2009; 88(5):423-30. DOI:10.1097/PHM.0b013e31819c59c6