CONSENSYS: an instrument to support CONtextual SENsitivity in SYStematic reviews
Background: Systematic reviews are considered important in answering what works, for whom and in which circumstances. They often include a section on implications for policymakers and practitioners, in which they discuss relevant options to engage with. Implementation sections are coloured by the cultural background, theoretical and disciplinary perspective of the reviewers formulating them. They do not necessarily consider local contexts in which the evidence needs to be applied, hence the recommendations may be too general to be useful. When policy makers and practitioners implement systematic review findings, the evidence presented needs to be translated to their local context.
Methods: We applied a multi-method approach in two main phases: in a developmental phase we conducted a literature review and inventoried theoretical models and frameworks addressing contextual dimensions impacting on decision making and extracted core theoretical categories from these models. We then conducted five trans-national focus groups to investigate how to best translate research evidence into implications for practice and policy. Based on these results, we developed a draft of the guiding instrument. In a testing phase, we first conducted a face validity procedure by inviting comments from experts in the field and second, piloted the instrument on existing review projects and an ongoing mixed-methods review.
Results: CONSENSYS is an instrument in the form of a checklist. It contains 52 contextual factors categorised as either of ecological and socio-cultural relevance or pitched as influencing actor. CONSENSYS facilitates the transfer from review evidence into practice.
Conclusions: CONSENSYS is a theoretical framework that serves as a structure thereby assisting (a) reviewers to formulate context-specific implications for policy and practice and (b) end-users of systematic reviews to translate the review evidence into local contexts. It is the first rigorously developed instrument that focusses on implications for policy and practice sections in systematic reviews.
Patient, public and/or healthcare consumer involvement: We engaged practitioners, academics as well as policy makers in the focus group study. The face validity procedure of the drafted instrument was organized with reviewers and methodologists.