title: Making sense of complex data: a mapping process for analyzing findings of a realist review on guideline implementability.
abstract: BACKGROUND
  Realist reviews offer a rigorous method to analyze heterogeneous data emerging from multiple disciplines as a means to develop new concepts, understand the relationships between them, and identify the evidentiary base underpinning them. However, emerging synthesis methods such as the Realist Review are not well operationalized and may be difficult for the novice researcher to grasp. The objective of this paper is to describe the development of an analytic process to organize and synthesize data from a realist review.
  
  
  METHODS
  Clinical practice guidelines have had an inconsistent and modest impact on clinical practice, which may in part be due to limitations in their design. This study illustrates the development of a transparent method for organizing and analyzing a complex data set informed by a Realist Review on guideline implementability to better understand the characteristics of guidelines that affect their uptake in practice (e.g., clarity, format). The data organization method consisted of 4 levels of refinement: 1) extraction and 2) organization of data; 3) creation of a conceptual map of guideline implementability; and 4) the development of a codebook of definitions.
  
  
  RESULTS
  This new method is comprised of four steps: data extraction, data organization, development of a conceptual map, and operationalization vis-a-vis a codebook. Applying this method, we extracted 1736 guideline attributes from 278 articles into a consensus-based set of categories, and collapsed them into 5 core conceptual domains for our guideline implementability map: Language, Format, Rigor of development, Feasibility, Decision-making.
  
  
  CONCLUSIONS
  This study advances analysis methods by offering a systematic approach to analyzing complex data sets where the goals are to condense, organize and identify relationships.
authors.affiliation: St, Michael's Hospital Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto M5B 1W8, ON, Canada. monika.kastner@utoronto.ca.
authors.forename: Monika
authors.initials: M
authors.lastname: Kastner
authors.forename: Julie
authors.initials: J
authors.lastname: Makarski
authors.forename: Leigh
authors.initials: L
authors.lastname: Hayden
authors.forename: Lisa
authors.initials: L
authors.lastname: Durocher
authors.forename: Ananda
authors.initials: A
authors.lastname: Chatterjee
authors.forename: Melissa
authors.initials: M
authors.lastname: Brouwers
authors.forename: Onil
authors.initials: O
authors.lastname: Bhattacharyya
mesh_terms: D006801:Humans; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D012196:Review Literature as Topic; D013223:Statistics as Topic
references.citation: Implement Sci. 2011 Jul 06;6:69
references.pmid: 21733160
references.citation: J Gen Intern Med. 2006 Feb;21 Suppl 2:S14-20
references.pmid: 16637955
references.citation: J Eval Clin Pract. 2009 Dec;15(6):1082-90
references.pmid: 20367709
references.citation: Soc Sci Med. 2005 Jul;61(2):417-30
references.pmid: 15893056
references.citation: J Health Serv Res Policy. 2005 Jul;10 Suppl 1:21-34
references.pmid: 16053581
references.citation: Implement Sci. 2010 May 26;5:38
references.pmid: 20504293
references.citation: Qual Health Care. 1993 Dec;2(4):243-8
references.pmid: 10132459
references.citation: BMC Public Health. 2011 Apr 10;11:222
references.pmid: 21477347
references.citation: BMC Med. 2013 Jan 29;11:21
references.pmid: 23360677
references.citation: CMAJ. 2004 Nov 9;171(10):1189-92
references.pmid: 15534311
references.citation: Med J Aust. 2004 Mar 15;180(S6):S50-1
references.pmid: 15012580
references.citation: BMC Med Educ. 2010 Feb 02;10:12
references.pmid: 20122253
references.citation: Implement Sci. 2012 Apr 19;7:33
references.pmid: 22515663
references.citation: BMJ. 2005 Nov 5;331(7524):1064-5
references.pmid: 16230312
references.citation: BMJ. 2004 Feb 7;328(7435):343-5
references.pmid: 14764503