Evidence map›Paper›PMID 30775017›Full record

ArticleBMJ global health2019

Implications of a complexity perspective for systematic reviews and guideline development in health decision making.

Mark Petticrew, Cécile Knai, James Thomas, Eva Annette Rehfuess, Jane Noyes, Ansgar Gerhardus, Jeremy M Grimshaw, Harry Rutter, Elizabeth McGill

Abstract read
In one paragraph

Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  9. Training Healthcare Professionals to Deliver a Group-Based Intervention for People Living With Severe Obesity: Lessons From the PROGROUP Feasibility Trial.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mark PetticrewFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Cécile KnaiFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
James ThomasEPPI-Centre, SSRU, Department of Social Science, UCL Institute of Education, University College London, London, UK.
Eva Annette RehfuessInstitute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
Jane NoyesSchool of Social Sciences, Bangor University, Bangor, UK.ORCID 0000-0003-4238-5984
Ansgar GerhardusInstitut für Public Health und Pflegeforschung, Universität Bremen, Bremen, Germany.
Jeremy M GrimshawClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
Harry RutterFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Elizabeth McGillFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

There is growing interest in the potential for complex systems perspectives in evaluation. This reflects a move away from interest in linear chains of cause-and-effect, towards considering health as an outcome of interlinked elements within a connected whole. Although systems-based approaches have a long history, their concrete implications for health decisions are still being assessed. Similarly, the implications of systems perspectives for the conduct of systematic reviews require further consideration. Such reviews underpin decisions about the implementation of effective interventions, and are a crucial part of the development of guidelines. Although they are tried and tested as a means of synthesising evidence on the effectiveness of interventions, their applicability to the synthesis of evidence about complex interventions and complex systems requires further investigation. This paper, one of a series of papers commissioned by the WHO, sets out the concrete methodological implications of a complexity perspective for the conduct of systematic reviews. It focuses on how review questions can be framed within a complexity perspective, and on the implications for the evidence that is reviewed. It proposes criteria which can be used to determine whether or not a complexity perspective will add value to a review or an evidence-based guideline, and describes how to operationalise key aspects of complexity as concrete research questions. Finally, it shows how these questions map onto specific types of evidence, with a focus on the role of qualitative and quantitative evidence, and other types of information.

Indexed as

complex interventionspublic healthsystematic reviewssystems

Identifiers

PMID30775017
PMCPMC6350708

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.