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Analytic Frameworks
- 1. Analytic Frameworks Prepared for: Agency for Healthcare Research and Quality (AHRQ) Training Modules for Systematic Reviews Methods Guide www.ahrq.gov
- 2. Systematic Review Process Overview
- 12. Sample Working Framework Harris RP, et al. Am J Prev Med 2001;20(Suppl):21-35.
- 13. Sample Screening and Treatment Framework Hartmann KE, et. Evidence Report/Technology Assessment No. 187. Available at: http://www.ahrq.gov/downloads/pub/evidence/pdf/bladder/bladder.pdf. Population Intervention Outcomes
- 14. Capturing the Context Analytic frameworks can provide a means of capturing contextual issues important to a review Vanderbilt University Evidence-based Practice Center. Systematic review protocol: traumatic brain injury and depression. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/77/367/TBI%20and%20Depression%20(2-9-2010).pdf.
Editor's Notes
- Analytic Frameworks
- Systematic Review Process Overview This slide illustrates the steps in the systematic review process. This module focuses on the development of analytic frameworks.
- Learning Objectives
- What Is an Analytic Framework? Analytic frameworks essentially provide a picture of the topic under review, helping to elucidate the ways in which the intervention under review may contribute to health outcomes in the target population in light of potential mediators and modifiers of effect. References: Agency for Healthcare Research and Quality. Topic development. In: Methods reference guide for effectiveness and comparative effectiveness reviews . Version 1.0. Rockville, MD: Agency for Healthcare Research and Quality; Draft Posted October 2007. p. 10-15. Available at: http://effectivehealthcare.ahrq.gov/repFiles/2007_10DraftMethodsGuide.pdf. Bravata DM, McDonald KM, Shojania KG, et al. Challenges in systematic reviews: synthesis of topics related to the delivery, organization, and financing of health care. Ann Intern Med 2005;142(Pt 2):1056-65. http://www.ncbi.nlm.nih.gov/pubmed/15968030 Mulrow C, Langhorne P, Grimshaw J. Integrating heterogeneous pieces of evidence in systematic reviews. Ann Intern Med 1997;127:989-95. http://www.ncbi.nlm.nih.gov/pubmed/9412305
- Why Use Analytic Frameworks? All systematic reviews conducted in the Evidence-based Practice Center Program have analytic frameworks. In addition to providing an overview of the topic being studied, analytic frameworks are especially useful for making it clear when assumptions are being made about how or under what circumstances an intervention is likely to have an effect. They provide an opportunity to explicitly describe other aspects of the project.
- The Importance of an Analytic Framework
- When To Use Analytic Frameworks Analytic frameworks can be powerful tools in a number of circumstances. References : Agency for Healthcare Research and Quality. Topic development. In: Methods reference guide for effectiveness and comparative effectiveness reviews . Version 1.0. Rockville, MD: Agency for Healthcare Research and Quality; Draft Posted October 2007. p. 10-15. Available at: http://effectivehealthcare.ahrq.gov/repFiles/2007_10DraftMethodsGuide.pdf. Bravata DM, McDonald KM, Shojania KG, et al. Challenges in systematic reviews: synthesis of topics related to the delivery, organization, and financing of health care. Ann Intern Med 2005;142(Pt 2):1056-65. http://www.ncbi.nlm.nih.gov/pubmed/15968030 Mulrow C, Langhorne P, Grimshaw J. Integrating heterogeneous pieces of evidence in systematic reviews. Ann Intern Med 1997;127:989-95. http://www.ncbi.nlm.nih.gov/pubmed/9412305
- Components There are several essential elements of an analytic framework. Frameworks should clearly identify the population and the intervention being studied. Linkages demonstrating where key questions arise should be clear and marked, and outcomes (both intermediate and health outcomes) should be identified. Comparators and clinical decision points may be included in an analytic framework, but are more often illustrated in a decision tree or influence diagram.
- Revising the Framework
- Depicting Essential Components: An Example This slide presents the building blocks of analytic frameworks, as described by the United States Preventive Services Task Force (USPSTF) and often used in the Evidence-based Practice Center program. These building blocks are somewhat arbitrary, and other frameworks could be established or used. Nevertheless, we recommend this set of conventions because it is published and used widely. We have attempted to provide examples in this slide set of multiple approaches. Note that although arrows always show linkages, they should be labeled when they are representing services or treatment so that it is clear what they are. Reference: Harris RP, Hefland M, Woolf SH, et al. Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med 2001;20(Suppl):21-35. http://www.ncbi.nlm.nih.gov/pubmed/11306229 Woolf SH, DiGuiseppi CG, Atkins D, et al. Developing evidence-based clinical practice guidelines: lessons learned by the US Preventive Services Task Force. Annu Rev Public Health 1996;17:511-38. http://www.ncbi.nlm.nih.gov/pubmed/8724238
- Key Research Questions Key questions are indicated on the analytic framework with their numbers and may be placed on either the lines or the boxes. Reference: Whitlock EP, Orleans CT, Pender N, et al. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med 2002;22:267-84. http://www.ncbi.nlm.nih.gov/pubmed/11988383
- Sample Working Framework Systematic reviews may examine the effects of screening, diagnosis, or treatment. This overall analytic framework includes both screening and treatment; the box surrounds the portion of the framework that would be used if the intervention being reviewed was the treatment, rather than the screening approach. Reference: Harris RP, Hefland M, Woolf SH, et al. Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med 2001;20(Suppl):21-35. http://www.ncbi.nlm.nih.gov/pubmed/11306229
- Sample Screening and Treatment Framework This slide is intended to demonstrate the ways in which elements of the PICOTS can be represented in the analytic framework. The population is defined on the far left, and the intervention is indicated with a diamond, while potential outcomes are listed to the far right. In this approach, diamonds indicate decision nodes, and since there are no intermediate outcomes, there are no squares with rounded corners. This is format is different than the one used by the USPSTF. Reference: Hartmann KE, McPheeters ML, Biller DH, et al. Treatment of Overactive Bladder in Women . Evidence Report/Technology Assessment No. 187 (Prepared by Vanderbilt University Evidence-based Practice Center under Contract No. 290-2007-10065-I). Rockville, MD: Agency for Healthcare Research and Quality, August 2009. AHRQ Publication No. 09-E017. Available at: http://www.ahrq.gov/downloads/pub/evidence/pdf/bladder/bladder.pdf.
- Capturing the Context This analytic framework includes contextual issues at both the individual level and the medical system level that could play into decisionmaking, access, and other factors that could potentially affect outcomes. References: Vanderbilt University Evidence-based Practice Center. Systematic review protocol: traumatic brain injury and depression. Rockville, MD: Agency for Healthcare Research and Quality, Posted December 9, 2009. Available at: http://www.effectivehealthcare.ahrq.gov/ehc/products/77/367/TBI%20and%20Depression%20(2-9-2010).pdf.
- Using the Framework
- Key Messages
- References (I)
- References (II)
- Author