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Roadmap for Narratively Describing Effects of Interventions in Systematic Reviews

White Paper

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Summary

This document provides an approach to writing plain language and narrative statements for key systematic review results. It serves two goals: facilitate writing narrative statements and enhance consistency across reviews. The document identifies overlapping constructs that can be used in narrative statements based on the evidence user perspective and context.

Key Messages

  • Plain-language, narrative statements are helpful for most stakeholders, especially high-level policymakers and the public.
  • Five constructs (direction of effect, size of effect, clinical importance, statistical significance, and strength of evidence) should be considered when describing effects, recognizing that not all constructs will apply to all results or audiences.
  • These constructs are not independent and greatly overlap.
  • Based on stakeholders and context, writers can determine the relative importance of the constructs to address in narrative statements. Oversimplification of findings may risk misunderstanding for some audiences, but too much detail can be difficult to read orunderstand for others.
  • Results should not be described solely based on their statistical significance.
  • In evidence summaries and structured abstracts, Evidence-based Practice Centers can use summary statistics alongside narrative statements when necessary to convey the findings more clearly. When possible, avoid narrative statements in which summary statistics break up the flow of a sentence.

Journal Citation

Murad MH, Fiordalisi C, Pillay J., et al. Making Narrative Statements to Describe Treatment Effects. J Gen Intern Med. 27 Oct 2020 [Epub ahead of print].

Citation

Gerrity M, Fiordalisi C, Pillay J, Wilt TJ, O'Connor E, Kahwati L, Hernandez AV, Rutter CM, Chou R, Balk EM, Steele DW, Saldanha IJ, Panagiotou OA, Chang S, Murad MH. Roadmap for Narratively Describing Effects of Interventions in Systematic Reviews. Methods White Paper. (Prepared by the Scientific Resource Center under Contract No. 290-2017-00003C.) AHRQ Publication No. 20(21)-EHC018. Rockville, MD: Agency for Healthcare Research and Quality. November 2020. Posted final reports are located on the Effective Health Care Program search page. DOI: 10.23970/AHRQEPCWHITEPAPERNARRATIVELY.