ReviewAnnals of family medicine
Systems and complexity thinking in the general practice literature: an integrative, historical narrative review.
Review in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 3 syntheses or guidelines pooled it, 135 citations in OpenAlex.
- Integrating Self-Management Education and Support in Routine Care of People With Type 2 Diabetes Mellitus: A Conceptional Model Based on Critical Interpretive Synthesis and A Consensus-Building Participatory Consultation.Frontiers in clinical diabetes and healthcare · 2022Pooled it
- Systems approach to health service design, delivery and improvement: a systematic review and meta-analysis.BMJ open · 2021Pooled it
- Criteria-Based Return to Sport Decision-Making Following Lateral Ankle Sprain Injury: a Systematic Review and Narrative Synthesis.Sports medicine (Auckland, N.Z.) · 2019Pooled it
- Factors facilitating the implementation of a clinical decision support system in primary care practices: a fuzzy set qualitative comparative analysis.BMC health services research · 2023Trial
- Systemic path to global health 2050.Bulletin of the World Health Organization · 2026Article
- Why family medicine requires a paradigm shift from linear guidelines to complexity science.Family medicine and community health · 2026Article
- Complexity Science in Domestic Abuse Literature: A Systematic Scoping Review.Trauma, violence & abuse · 2026Article
- Strengthening integration of pathways into general practice in Australia: a virtual workshop study with stakeholders.BJGP open · 2026Article
- Exploring a Systems-Based Model of Care for Effective Healthcare Transformation: A Narrative Review in Implementation Science of Saudi Arabia's Vision 2030 Experience.Healthcare (Basel, Switzerland) · 2025Article
- If things were simple, word would have gotten around. Can complexity science help us improve pediatric research?Pediatric research · 2025Review
- The scope of emergency nursing viewed through the lens of complex adaptive systems: A discussion paper.International journal of nursing studies advances · 2025Review
- Primary health care strengthening through the lens of healthcare system thinking.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- A Study Protocol for the Macro-analysis of Iran's Health System with System Dynamics Approach.Medical journal of the Islamic Republic of Iran · 2025Article
- Evolving through multiple, co-existing pressures to change: a case study of self-organization in primary care during the COVID-19 pandemic in Canada.BMC primary care · 2024Article
- Storylines of family medicine II: foundational building blocks-context, community and health.Family medicine and community health · 2024Article
- Community hospitals of the future: the role of community hospitals to mitigate health system burden in Singapore.Frontiers in health services · 2024Article
- Article
- Physicians' experiences and actions in making complex level-of-care decisions during acute situations within older patients' homes: a critical incident study.BMC geriatrics · 2023Article
- Orientation of One Health development: think globally and act locally.Science in One Health · 2023Review
- Using systems perspectives in evidence synthesis: A methodological mapping review.Research synthesis methods · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOver the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. We assessed the impact of complexity science on general practice/family medicine.
methodsWe performed a historical integrative review using the following systematic search strategy: medical subject heading [humans] combined in turn with the terms complex adaptive systems, nonlinear dynamics, systems biology, and systems theory, limited to general practice/family medicine and published before December 2010. A total of 16,242 articles were retrieved, of which 49 were published in general practice/family medicine journals. Hand searches and snowballing retrieved another 35. After a full-text review, we included 56 articles dealing specifically with systems sciences and general/family practice.
resultsGeneral practice/family medicine engaged with the emerging systems and complexity theories in 4 stages. Before 1995, articles tended to explore common phenomenologic general practice/family medicine experiences. Between 1995 and 2000, articles described the complex adaptive nature of this discipline. Those published between 2000 and 2005 focused on describing the system dynamics of medical practice. After 2005, articles increasingly applied the breadth of complex science theories to health care, health care reform, and the future of medicine.
conclusionsThis historical review describes the development of general practice/family medicine in relation to complex adaptive systems theories, and shows how systems sciences more accurately reflect the discipline's philosophy and identity. Analysis suggests that general practice/family medicine first embraced systems theories through conscious reorganization of its boundaries and scope, before applying empirical tools. Future research should concentrate on applying nonlinear dynamics and empirical modeling to patient care, and to organizing and developing local practices, engaging in community development, and influencing health care reform.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.