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Analytic Frameworks

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Analytic Frameworks. Prepared for: Agency for Healthcare Research and Quality (AHRQ), Training Modules for Systematic Reviews Methods Guide, www.ahrq.gov
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Analytic Frameworks

Systematic Review Process Overview. This figure presents an overview of the steps in the systematic review process. The first step, the preparation of the topic, requires refining the topic and developing an analytic framework. The second step is to search for and select studies for inclusion, which involves identifying study eligibility criteria, searching for relevant studies, and selecting evidence for inclusion. The third step is to extract data from individual studies. The fourth step is to analyze and synthesize studies, which involves assessing the quality of individual studies, assessing applicability, presenting findings in tables, synthesizing quantitative data, and grading the strength of evidence. The final step is to report the systematic review. This module focuses on the development of analytic frameworks.
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Systematic Review Process Overview

Keywords: systematic review | topic refinement | analytic framework | eligibility criteria | data extraction
Learning Objectives. To understand the use of analytic frameworks within systematic reviews; to develop an understanding of principles for developing analytic frameworks; to understand which elements of a review can be represented in an analytic framework.
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Learning Objectives

Keywords: analytic framework
What Is an Analytic Framework? A type of evidence model that links and defines clinical concepts, evidence, and populations as they relate to outcomes. Sometimes referred to as causal pathways. Alternative and related concepts are: Conceptual frameworks, Influence diagrams, Theoretical frameworks, Logic models.
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What Is an Analytic Framework?

Keywords: intervention | health outcomes | population
Why Use Analytic Frameworks? To provide clinical, biological, or health services underpinnings for the mechanism of action. To clarify implicit assumptions. To identify logical flaws as key questions are developed. To provide a starting point for discussions with key informants. To identify distinct bodies of evidence to be included in the review.
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Why Use Analytic Frameworks?

Keywords: systematic review | Evidence-based Practice Center
The Importance of an Analytic Framework. Specifies populations, interventions, and outcomes, and sometimes comparators, timing, and settings. Identifies potential modifiers and mediators of effectiveness. Clarifies links between intermediate and health outcomes.
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The Importance of an Analytic Framework

Keywords: PICOTS | mediators | health outcomes
When To Use Analytic Frameworks. Complex bodies of literature with multiple key questions: analytic frameworks help define key questions, and thus direct specific literature searches. Complex chain of logic between intermediate and clinical outcomes: analytic frameworks help users understand decisional context.
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When To Use Analytic Frameworks

Keywords: key questions | literature search | clinical outcomes
Components. Population of interest. Intervention. Linkages that demonstrate key questions. Intermediate outcomes. Ultimate health outcomes (including harms).
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Components

Keywords: population | intervention | key question | health outcomes | comparator
Revising the Framework. The population, intervention, and outcomes should be clearly identified in the analytic framework. All key questions should be represented clearly on the framework. Contextual information about modifiers and mediators may be appropriate. Analytic frameworks are drafted with the purpose of clarifying complex questions and will need iterative revisions through the topic refinement process (see the module, “Topic Refinement”).
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Revising the Framework

Keywords: PICOTS | key question | mediators | topic refinement
Depicting Essential Components: An Example. Graphical chain of logic: Arrows - Linkages, Preventive service or treatment, Questions. Dotted lines – Associations. Rectangles - Intermediate outcomes, Rounded corners; Health states, Square corners. Curved arrows - Lead to ovals, Harms
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Depicting Essential Components: An Example

Keywords: analytic framework | components | Evidence-based Practice Center
This figure shows a blank portion of an analytic framework with a box with rounded edges connected to another box with rounded edges, which is then connected to a sharp-edged box. These represent two intermediate outcomes leading to a final health outcome. An arrow leads down from the figure to an oval shape, representing a potential harm. The framework also has an arrow leading directly form the first box to the final health outcomes box, indicating that there may also be a direct relationship.
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Key Research Questions

Keywords: key question | analytic framework | components | Evidence-based Practice Center
This figure shows a sample working framework. It begins on the left side with persons at risk. A solid arrow labeled “Screening” leads to a round-edged rectangle that represents “Early Detection of a Target Condition.” A curvy arrow leads down to an oval representing “Adverse Effects of Screening.” A solid arrow labeled “Treatment” leads right from the first box to another round-edged rectangle representing “Intermediate Outcomes.” Another curvy arrow leads down to an oval representing “Adverse Effects of Treatment.” Finally, a dotted line leads from the “Intermediate Outcomes” box to a sharp-edged box that represents the ultimate health outcome: “Reduced Morbidity and/or Mortality.”
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Sample Working Framework

Keywords: systematic review | analytic framework
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