Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]

Background: The intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) has been developed to facilitate detailed assessments of intervention complexity in systematic reviews. Worked examples of the tool’s application are needed to promote its use and refinement. The aim of this cas...

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Main Authors: Cathal A. Cadogan, Audrey Rankin, Simon Lewin, Carmel M. Hughes
Format: Article
Language:English
Published: F1000 Research Ltd 2020-06-01
Series:HRB Open Research
Online Access:https://hrbopenresearch.org/articles/3-31/v1
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spelling doaj-503d2848bc0c4dd49fa96eccd762c5e62020-11-25T04:05:17ZengF1000 Research LtdHRB Open Research2515-48262020-06-01310.12688/hrbopenres.13044.114140Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]Cathal A. Cadogan0Audrey Rankin1Simon Lewin2Carmel M. Hughes3School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, IrelandSchool of Pharmacy, Queen’s University Belfast, Belfast, UKDivision of Health Services, Norwegian Institute of Public Health, Oslo, NorwaySchool of Pharmacy, Queen’s University Belfast, Belfast, UKBackground: The intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) has been developed to facilitate detailed assessments of intervention complexity in systematic reviews. Worked examples of the tool’s application are needed to promote its use and refinement. The aim of this case study was to apply the iCAT_SR to a subset of 20 studies included in a Cochrane review of interventions aimed at improving appropriate polypharmacy in older people. Methods: Interventions were assessed independently by two authors using the six core iCAT_SR dimensions: (1) ‘Target organisational levels/categories’; (2) ‘Target behaviour/actions’; (3) ‘Active intervention components’; (4) ‘Degree of tailoring’; (5) ‘Level of skill required by intervention deliverers’; (6) ‘Level of skill required by intervention recipients’. Attempts were made to apply four optional dimensions: ‘Interaction between intervention components’; ‘Context/setting’; ‘Recipient/provider factors’; ‘Nature of causal pathway’. Inter-rater reliability was assessed using Cohen’s Kappa coefficient. Disagreements were resolved by consensus discussion. The findings are presented narratively. Results: Assessments involving the core iCAT_SR dimensions showed limited consistency in intervention complexity across included studies, even when categorised according to clinical setting. Interventions were delivered across various organisational levels and categories (i.e. healthcare professionals and patients) and typically comprised multiple components. Intermediate skill levels were required by those delivering and receiving the interventions across all studies. A lack of detail in study reports precluded application of the iCAT_SR’s optional dimensions. The inter-rater reliability was substantial (Cohen's Kappa = 0.75) Conclusions: This study describes the application of the iCAT_SR to studies included in a Cochrane systematic review. Future intervention studies need to ensure more detailed reporting of interventions, context and the causal pathways underlying intervention effects to allow a more holistic understanding of intervention complexity and facilitate replication in other settings. The experience gained has helped to refine the original guidance document relating to the application of iCAT_SR.https://hrbopenresearch.org/articles/3-31/v1
collection DOAJ
language English
format Article
sources DOAJ
author Cathal A. Cadogan
Audrey Rankin
Simon Lewin
Carmel M. Hughes
spellingShingle Cathal A. Cadogan
Audrey Rankin
Simon Lewin
Carmel M. Hughes
Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]
HRB Open Research
author_facet Cathal A. Cadogan
Audrey Rankin
Simon Lewin
Carmel M. Hughes
author_sort Cathal A. Cadogan
title Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]
title_short Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]
title_full Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]
title_fullStr Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]
title_full_unstemmed Application of the intervention Complexity Assessment Tool for Systematic Reviews within a Cochrane review: an illustrative case study [version 1; peer review: 3 approved]
title_sort application of the intervention complexity assessment tool for systematic reviews within a cochrane review: an illustrative case study [version 1; peer review: 3 approved]
publisher F1000 Research Ltd
series HRB Open Research
issn 2515-4826
publishDate 2020-06-01
description Background: The intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) has been developed to facilitate detailed assessments of intervention complexity in systematic reviews. Worked examples of the tool’s application are needed to promote its use and refinement. The aim of this case study was to apply the iCAT_SR to a subset of 20 studies included in a Cochrane review of interventions aimed at improving appropriate polypharmacy in older people. Methods: Interventions were assessed independently by two authors using the six core iCAT_SR dimensions: (1) ‘Target organisational levels/categories’; (2) ‘Target behaviour/actions’; (3) ‘Active intervention components’; (4) ‘Degree of tailoring’; (5) ‘Level of skill required by intervention deliverers’; (6) ‘Level of skill required by intervention recipients’. Attempts were made to apply four optional dimensions: ‘Interaction between intervention components’; ‘Context/setting’; ‘Recipient/provider factors’; ‘Nature of causal pathway’. Inter-rater reliability was assessed using Cohen’s Kappa coefficient. Disagreements were resolved by consensus discussion. The findings are presented narratively. Results: Assessments involving the core iCAT_SR dimensions showed limited consistency in intervention complexity across included studies, even when categorised according to clinical setting. Interventions were delivered across various organisational levels and categories (i.e. healthcare professionals and patients) and typically comprised multiple components. Intermediate skill levels were required by those delivering and receiving the interventions across all studies. A lack of detail in study reports precluded application of the iCAT_SR’s optional dimensions. The inter-rater reliability was substantial (Cohen's Kappa = 0.75) Conclusions: This study describes the application of the iCAT_SR to studies included in a Cochrane systematic review. Future intervention studies need to ensure more detailed reporting of interventions, context and the causal pathways underlying intervention effects to allow a more holistic understanding of intervention complexity and facilitate replication in other settings. The experience gained has helped to refine the original guidance document relating to the application of iCAT_SR.
url https://hrbopenresearch.org/articles/3-31/v1
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