The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.

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Cochrane Handbook for Systematic Reviews of Interventions

Part One: The Context Of Educational Research Part Two: Planning Educational Research Part Three: Styles Of Educational Research Part Four: Strategies And Instruments For Data Collection And Researching Part Five: Data Analysis

Research Methods in Education

Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols--PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols.

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Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation.

There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies. We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved. We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses. We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.

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Methods for the thematic synthesis of qualitative research in systematic reviews

An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of “implementation outcomes” distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working “taxonomy” of eight conceptually distinct implementation outcomes—acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability—along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.

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Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda

As Roe et al 1 point out, failing to ensure access to paediatric appointments has implications for a range of outcomes, including safeguarding. Here we report challenges we experienced in finding out from the frontline how protocols intended to address this problem are experienced on the ground.

Following our did not attend (DNA)2 3 studies, we reviewed recruitment notes on our attempts to talk to people tasked with producing or implementing these protocols. After speedy institutional ethics review, we required research and development (R&D) approval from each trust where we had identified a relevant DNA protocol in order to ask potential interviewees if we could talk to them. R&D contacts were helpful but risk-averse. Challenges included …

https://adc.bmj.com/content/archdischild/102/8/786.full.pdf

Bureaucracy, trust and time: recruitment in a low-risk study of paediatric protocols forchildren who miss medicalappointments.

<h3>Objectives</h3> Children and young people (CYP) presenting with a mental health (MH) crisis are frequently admitted to general acute paediatric wards as a place of safety. A recent systematic review of interventions to avoid inpatient admissions for CYP presenting in MH crisis<sup>1</sup> showed that evidence is poor and limited. Meaning that CYP are likely to continue to need to be admitted in crisis, with paediatric wards a common allocation whilst waiting for assessment given the lack of direct access to specialist mental health wards for most children. Anecdotal reports from within the paediatric community internationally confirm that numbers of such admissions have increased, as has acuity. Teams are increasingly caring for CYP under the Mental Health Act, using restrictive practices sometimes without mental health liaison support. Moreover, no data have been published on the outcomes for CYP, patient experience, or whether such admissions may be avoidable or better managed in other settings. Therefore, we aim to conduct a rapid review of the literature since 1990 on the impact of mental health on paediatric admissions. This rapid systematic review will also inform the Mental Health Admissions to Paediatric Wards Study (MAPS), NIHR-funded mixed methods study, the relevant evidence about the factors that influence decisions to admit CYP to paediatric wards for primary MH problems. <h3>Methods</h3> We will undertake a rapid review of the literature following PRISMA guidelines. We will search across four databases (PubMed, Embase, PsycINFO and Web of Science) and an additional search of Google Scholar to identify unpublished data or additional studies. Search strategies will be tailored for each database but in summary, searches will consist of search terms combining three overall domains: (admissions) AND (paediatric or children’s wards) AND (mental health diagnosis/problem). We will include observational and qualitative studies, randomized and non-randomized controlled trials and reports published by professional bodies that report trends in the number of admissions, risk factors for adverse care for CYP and families during admissions, views/experiences of CYP, families and health professionals during admissions to paediatric wards and interventions that aim to improve the care of CYP and families during admissions. The results of the search will be imported into Covidence, an online software tool for systematic reviews. Duplicate records will be removed using Covidence. <h3>Results</h3> Screening and extraction of the data are still in progress and results will be available at the conference. <h3>Conclusions</h3> This rapid review is essential to synthesise the evidence available not only about the trends of admissions but also about the reasons for admissions, the contributing factors to the admissions, the clinical needs of CYP when admitted, and the views/experiences of CYP, families and health professionals to understand the context of care. <h3>Reference</h3> Clisu D, Layther I, Dover D, Viner RM, Read T, Cheesman D, Hodges S, Hudson LD. Alternatives to mental health admissions for children and adolescents experiencing mental health crises: a systematic review of the literature. 2021. <i>Clin Child Psychol Psychiatry.</i> (in press). 

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Helen Roberts

Papers

Bureaucracy, trust and time: recruitment in a low-risk study of paediatric protocols forchildren who miss medicalappointments.

1843 Admissions to paediatric wards with a primary mental health diagnosis: a rapid review