Advancing Methods for Overviews of Reviews of Healthcare Interventions

  • Author / Creator
    Pollock, Michelle
  • Background: Overviews of reviews of healthcare interventions (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for health-care decision-making. Their increasing popularity, combined with a lack of evidence-based guidance for their conduct and reporting, creates a knowledge gap that must be addressed. The objective of this thesis was to examine methods for conducting and reporting overviews. Methods: This thesis consisted of three studies and one protocol. First, a scoping review was conducted to identify and summarize all existing methodological guidance for conducting overviews of healthcare interventions. Then, the results of the scoping review were used to inform the development of two methods studies to provide empirical evidence on outstanding issues related to conducting overviews. One study was a multiple case study that explored the impact of different inclusion decisions on the comprehensiveness and results of overviews. The other was a descriptive study that examined issues related to using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) to assess methodological quality of SRs included in overviews. Lastly, a study protocol outlined a project plan to develop a reporting guideline for overviews. Results: First, the scoping review found limited guidance, and a number of challenges, for conducting several steps of the overview process, such as including non-Cochrane SRs in overviews and conducting quality assessments. Second, the multiple case study found that different inclusion decisions led to different amounts of outcome data loss and change across overviews, and presented an evidence-based decision tool to help researchers make inclusion decisions in overviews. Third, the descriptive study found that AMSTAR can be used successfully in overviews, and that using AMSTAR scores as an exclusion criterion may not introduce bias into the overview process. Lastly, a study protocol described methods for the development of PRIOR (Preferred Reporting Items for Overviews of Reviews), an evidence-based and consensus-based reporting guideline for overviews. Conclusions: While gaps in guidance still exist, these thesis projects play an important role in advancing methods for conducting and reporting overviews of reviews of healthcare interventions. Strengthening overview methods can help ensure a rigorous and valid evidence base for knowledge translation and dissemination.

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  • Graduation date
    Spring 2018
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
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  • Department
  • Supervisor / co-supervisor and their department(s)
  • Examining committee members and their departments
    • Scott, Shannon (Nursing)
    • Turner, Justine (Pediatrics)
    • Fernandes, Ricardo (Pediatrics)
    • Newton, Amanda (Pediatrics)
    • Clark, Alexander (Nursing)
    • Furlan, Andrea (Medicine)