Practising reflexivity in systematic reviews – what can we learn from qualitative research for all types of reviews?
2Cochrane Person-Centre Care, Health Systems and Public Health Thematic Group, Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Norway, Norway
3Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway, Norway
Background Randomised trials and other quantitative research methods aim to protect data from bias. This reflects a view of evidence as something that can be achieved in its ‘pure state’ once all sources of bias have been removed, including the perspective of the researcher. One way of safeguarding research from researchers’ personal biases is to require conflict-of-interest statements and to exclude authors who have unacceptable conflicts. Within qualitative research traditions, however, the influence of the researcher is seen as unavoidable. Evidence is seen as a co-production between researchers and their informants. Research findings are therefore inextricably linked with the perspectives of the researcher. Here, there is less focus on conflicts of interest. Instead, qualitative researchers are encouraged to consider how they and their research have interacted with and influenced each other, a concept referred to as ‘researcher reflexivity’. Cochrane’s conflict of interest declarations have traditionally focused on financial interests. Recently, Cochrane has also required authors to declare non-financial interests, including professional or ideological interests. Unlike financial conflicts, these interests do not prevent participation in reviews. However, Cochrane encourages authors to think critically about how these perspectives and experiences have shaped their development of the review. Although this may be useful, Cochrane offers little guidance about how this exercise should be performed. Here, qualitative research traditions of reflexivity may be helpful. Objectives To explore the concept of reflexivity in the context of Cochrane reviews and offer practical guidance about how review authors can practice reflexivity. Results We will discuss the concept of reflexivity and our experiences with reflexivity in Cochrane reviews. We will offer practical advice regarding how review authors can practice reflexivity, including questions that may help facilitate this process as part of their declarations of interest and throughout the review. Finally, we will discuss how this process can be reported in the review. Relevance to patients Reflexive processes may help review authors better understand their research choices and lead to more robust evidence for patients and other stakeholders.