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Support for producing systematic reviews about health systems is less well developed than for those about clinical practice. From interviewing policy makers and systematic reviewers we identified institutional mechanisms which bring systematic reviews and policy priorities closer by harnessing organisational and individual motivations, emphasising engagement between policy and research, embedding efforts in conducive structures and supporting them with formalised procedures. Four models combine mechanisms appropriately to suit the initial degree of clarity and consensus of key issues underpinning the policy problem or research question, and whether the review is for a specific decision or widespread use.
This study employed insider research and reflective practice to investigate exchanges across the research-policy interface to understand the practice of producing policy-relevant systematic reviews. Interviewees came from 11 systematic reviews or review programmes which spanned four models of policy-relevant reviews and between them provided evidence for understanding policy problems, comparing policy options, or implementing policy decisions. No review methodology was found to be uniquely appropriate for policy-relevant systematic reviews. It was the mutual engagement across the research-policy interface that made the reviews policy-relevant. This involved thinking about the issues and seeing them from multiple viewpoints to identify and shape questions; this prompted implicit or explicit value-driven debates. The intellectual work to shape a policy-relevant systematic review is an iterative, collective endeavour that requires partners from either side of the policy-research interface to engage with the unfamiliar, listen, challenge and co-construct questions and answers.
When swift, accurate appraisal of evidence is required to inform policy concerning broad research questions, and budgetary constraints limit the employment of large research teams, researchers face a significant challenge which is sometimes met by reviewing existing systematic reviews. In this paper we highlight the challenges inherent in the reviews of reviews (RoR) method in order to advance understanding of this important tool for policy makers. Drawing on our experiences, we present, where possible, potential solutions to these challenges to demonstrate that RoRs, despite their limitations, can be useful for mediating policy-relevant evidence at speed.
