title: Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
abstract: OBJECTIVE
  The purpose of this Agency for Healthcare Research and Quality Evidence-based Practice Center methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions.
  
  
  METHODS
  We performed a literature scan and conducted semistructured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions (CMCIs) or organizational leaders who implement CMCIs in health care.
  
  
  RESULTS
  Challenges identified include lack of consistent terminology for such interventions (eg, complex, multicomponent, multidimensional, multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from holistic to individual component analytic approaches; and incomplete and inconsistent reporting of elements critical to understanding the success and impact of multicomponent interventions, such as methods used for implementation the context in which interventions are implemented.
  
  
  CONCLUSIONS
  We provide a framework for the spectrum of conceptual and analytic approaches to synthesizing studies of multicomponent interventions and an initial list of critical reporting elements for such studies. This information is intended to help systematic reviewers understand the options and tradeoffs available for such reviews.
authors.affiliation: Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Research Foundation, 3710 SW US Veterans Hospital Road, Mailcode R&D71, Portland, OR 97239, USA. Electronic address: guisej@ohsu.edu.
authors.forename: Jeanne-Marie
authors.initials: JM
authors.lastname: Guise
authors.affiliation: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Chang
authors.affiliation: RTI-UNC Evidence-based Practice Center, 3400 E. Cornwallis Rd., Research Triangle Park, NC 27709, USA.
authors.forename: Meera
authors.initials: M
authors.lastname: Viswanathan
authors.affiliation: Blue Cross Blue Shield Evidence-based Practice Center, 225 North Michigan Avenue, Chicago, IL 60601, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Glick
authors.affiliation: ECRI-Penn Evidence-based Practice Center, 5200 Butler Pike, Plymouth Meeting, PA 19462, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Treadwell
authors.affiliation: ECRI-Penn Evidence-based Practice Center, 5200 Butler Pike, Plymouth Meeting, PA 19462, USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Umscheid
authors.affiliation: Kaiser Evidence-based Practice Center, 3800 N. Interstate Ave., Portland, OR 97227, USA.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Whitlock
authors.affiliation: Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Research Foundation, 3710 SW US Veterans Hospital Road, Mailcode R&D71, Portland, OR 97239, USA.
authors.forename: Rongwei
authors.initials: R
authors.lastname: Fu
authors.affiliation: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA.
authors.forename: Elise
authors.initials: E
authors.lastname: Berliner
authors.affiliation: Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Research Foundation, 3710 SW US Veterans Hospital Road, Mailcode R&D71, Portland, OR 97239, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Paynter
authors.affiliation: Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Research Foundation, 3710 SW US Veterans Hospital Road, Mailcode R&D71, Portland, OR 97239, USA.
authors.forename: Johanna
authors.initials: J
authors.lastname: Anderson
authors.affiliation: Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Research Foundation, 3710 SW US Veterans Hospital Road, Mailcode R&D71, Portland, OR 97239, USA.
authors.forename: Pua
authors.initials: P
authors.lastname: Motu'apuaka
authors.affiliation: Brown Evidence-based Practice Center, Brown University, 1 Prospect Street, Providence, RI 02912, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Trikalinos
mesh_terms: D003695:Delivery of Health Care / Q000379:methods* / Q000592:standards*; D019317:Evidence-Based Medicine; D006302:Health Services Research / Q000379:methods* / Q000592:standards*; D006801:Humans; D012107:Research Design; D014481:United States; D016270:United States Agency for Healthcare Research and Quality
keywords: Complex interventions; Complexity; Evidence synthesis methods; Evidence-based medicine; Multicomponent interventions; Reporting guideline; Systematic reviews