Protocol - Realist and meta-narrative evidence synthesis: Evolving Standards (RAMESES)

Healthcare Innovation and Policy Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London E1 2AB, UK.
BMC Medical Research Methodology (Impact Factor: 2.27). 08/2011; 11(1):115. DOI: 10.1186/1471-2288-11-115
Source: PubMed


There is growing interest in theory-driven, qualitative and mixed-method approaches to systematic review as an alternative to (or to extend and supplement) conventional Cochrane-style reviews. These approaches offer the potential to expand the knowledge base in policy-relevant areas - for example by explaining the success, failure or mixed fortunes of complex interventions. However, the quality of such reviews can be difficult to assess. This study aims to produce methodological guidance, publication standards and training resources for those seeking to use the realist and/or meta-narrative approach to systematic review.
We will: [a] collate and summarise existing literature on the principles of good practice in realist and meta-narrative systematic review; [b] consider the extent to which these principles have been followed by published and in-progress reviews, thereby identifying how rigour may be lost and how existing methods could be improved; [c] using an online Delphi method with an interdisciplinary panel of experts from academia and policy, produce a draft set of methodological steps and publication standards; [d] produce training materials with learning outcomes linked to these steps; [e] pilot these standards and training materials prospectively on real reviews-in-progress, capturing methodological and other challenges as they arise; [f] synthesise expert input, evidence review and real-time problem analysis into more definitive guidance and standards; [g] disseminate outputs to audiences in academia and policy. The outputs of the study will be threefold:1. Quality standards and methodological guidance for realist and meta-narrative reviews for use by researchers, research sponsors, students and supervisors2. A 'RAMESES' (Realist and Meta-review Evidence Synthesis: Evolving Standards) statement (comparable to CONSORT or PRISMA) of publication standards for such reviews, published in an open-access academic journal.3. A training module for researchers, including learning outcomes, outline course materials and assessment criteria.
Realist and meta-narrative review are relatively new approaches to systematic review whose overall place in the secondary research toolkit is not yet fully established. As with all secondary research methods, guidance on quality assurance and uniform reporting is an important step towards improving quality and consistency of studies.

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    • "On the other hand, positivist methods including content analysis and qualitative comparative analysis [e.g., 69] can also be used. Second, realist reviews (also called meta-narrative reviews or qualitative evidence synthesis reviews) are theory-driven interpretative reviews that were developed to inform, enhance, extend or alternatively supplement conventional systematic reviews by making sense of heterogeneous evidence about complex interventions applied in diverse contexts in a way that informs policy decision making [86]. They originated from criticisms of conventional systematic reviews and meta-analyses of noncomplex interventions that center on their simplistic, positivist underlying assumptions [87]. "
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    ABSTRACT: In this article we develop a typology of review types and provide a descriptive insight into the most common reviews found in top IS journals. Our assessment reveals that the number of IS reviews has increased over the years. The majority of the 139 reviews are theoretical in nature, followed by narrative reviews, meta-analyses, descriptive reviews, hybrid reviews, critical reviews, and scoping reviews. Considering the calls for IS research to develop a cumulative tradition, we hope more review articles will be published in the future and encourage researchers who start a review to use our typology to position their contribution.
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    • "Finally, the Ophelia process draws upon realist methods. Realist methods are best known in the health sector through the recent popularity of realist synthesis [45-49]. The central feature of realist methods is the focus on the mechanisms by which programs have an effect, and the recognition that different mechanisms may be activated by different interventions in different contexts and for different people [49,50]. "
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    • "Realism understands causation, as working through mechanisms that operate, or not, according to context [27]. Realist approaches build plausible, evidenced explanations of observed outcomes, often for complex social interventions that have multiple components, operate across multiple sites, and involve multiple actors or agents [28,29]. The underlying premise is that the observed ‘demi-regular patterns’ of interactions between the components that make up complex interventions can be explained by mid-range theories. "
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