ReviewBMC medical research methodology2020
When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions.
Review in BMC medical research methodology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 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
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Guideline
- Meta-analysis of economic evaluation studies: data harmonisation and methodological issues.BMC health services research · 2022Pooled it
- Conducting evidence synthesis and developing evidence-based advice in public health and beyond: A scoping review and map of methods guidance.Research synthesis methods · 2026Article
- Beyond Compliance: Understanding the Role of Peer Review Through a Theory of Change.Journal of evaluation in clinical practice · 2026Article
- Our journey, our stories: The lived experiences of parents/caregivers of children with severe neurodevelopmental disorders and behavioural complexity requiring examinations under anaesthesia.Paediatrics & child health · 2025Article
- Clinical practice guideline recommendations can promote or undermine health equity.Clinical and public health guidelines · 2025Article
- Towards development of guidelines for harnessing implementation science for suicide prevention: an international Delphi expert consensus study.BMJ public health · 2025Article
- Applying the WHO-INTEGRATE evidence-to-decision framework in the development of WHO guidelines on parenting interventions: step-by-step process and lessons learnt.Health research policy and systems · 2024Article
- Fertility education: recommendations for developing and implementing tools to improve fertility literacy†.Human reproduction (Oxford, England) · 2024Article
- Article
- Preventive care recommendations to promote health equity.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- What can the citations of systematic reviews of ethical literature tell us about their use?-an explorative empirical analysis of 31 reviews.Systematic reviews · 2023Article
- Physician- and patient-reported barriers to hepatocellular carcinoma surveillance: A nationwide survey.Medicine · 2022Article
- Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus?Frontiers in medicine · 2022Article
- [Evidence-based public health: perspectives and specific implementation factors].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2021Review
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
Abstract
backgroundGuidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be adopted in guideline development to facilitate a more nuanced consideration of a range of factors pertinent to decisions regarding public health and health system interventions. These factors include acceptability and feasibility, and societal, economic, and equity and equality implications of interventions. MAIN MESSAGE: A 5-step process describes how to incorporate a complexity perspective in guideline development with examples to illustrate each step. The steps include: (i) guideline scoping, (ii) formulating questions, (iii) retrieving and synthesising evidence, (iv) assessing the evidence, and (v) developing recommendations. Guideline scoping using stakeholder consultations, complexity features, evidence mapping, logic modelling, and explicit decision criteria is emphasised as a key step that informs all subsequent steps.
conclusionsThrough explicit consideration of a range of factors and enhanced understanding of the specific circumstances in which interventions work, a complexity perspective can yield guidelines with better informed recommendations and facilitate local adaptation and implementation. Further work will need to look into the methods of collecting and assessing different types of evidence beyond effectiveness and develop procedural guidance for prioritising across a range of decision criteria.
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.