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Chapter 2 Methods 7

Step Three

The synthesis in this stage explored the
relationship between different factors in the design
and operation of the co-ordination/integration
effort and study outcomes. A narrative numerical
synthesis approach was used. Each study in
the review was given an overall results code:
Positive (where all or the majority of results were
positive), Negative (where all or the majority
of the results were negative), or Mixed (where
the results were an equal mix of positive and
negative). The definition of positive and negative
used above was used here. These results were
compared across the different ways in which the
co-ordination/integration effort was organised
and delivered in studies in the review to identify
possible key factors in such efforts. This analysis
was exploratory only, the intention being to
identify factors that could be investigated in future
studies and or supported by reference to the wider
literature on the topic. However, given the paucity
of high quality studies, the limited measures of
outcome used and the lack of detail in reporting of
the actual mechanisms used to improve the co-
ordination of service delivery, it was not possible
to identify a basis for exploring similarities and
differences between projects and linking these to
patterns of outcomes.

2.7.5 Synthesis of economic analysis

Three studies in the in-depth review conducted
an economic analysis that estimated the financial
impacts of the project. The differences in the
way that the projects had undertaken the analysis
meant that it was not possible to synthesise the
results from individual studies. Instead the findings
from these studies are described along with an
assessment of the quality of the economic analysis
undertaken.

2.8 In-depth review: quality
assurance process

A training exercise was held for all review team
members to discuss the inclusion criteria and data
extraction for in-depth analysis to ensure overall
consistency. During the session, all team members
completed one in-depth data extraction on the
same study and compared their results.

Each review team member was allocated a set of
studies that were included in the systematic map
and subsequently applied the in-depth criteria.
Data-extraction and assessment of the Weight of
Evidence was then conducted by a pair of review
team members working independently initially
before comparing their decisions and coming to a
consensus. An agreed version of the data extraction
of each study was entered into the EPPI-Reviewer
homepage for synthesis.



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