The systematic review methodology represented by Cochrane is the mainstream both at home and abroad currently. Although its standardized procesdures have contributed to large amount of high-quality research evidence for policy-making and clinical practice, it has the unavoidable defect of poor external validity. Realist review is a theory-driven systematic review methodology for complex interventions under the realism philosophy. It does not answer the effectiveness questions but to uncover the mechanism as to how intervention works. Realist review starts with one or more candidate program theories that can explain the research question. By integrating relevant research evidence or documents, researchers look for the potential context-mechanism-outcome configurations and the recurrent patterns of program functioning, namely demi-regularities. Researchers iteratively test, refute and refine the candidate program theories, and obtain a deeper theoretical understanding of complex interventions and provide contextual recommendations for policy makers or clinical practitioners. In this paper, the characteristics of complex interventions, realism philosophy, research purpose and steps of conducting a realist review and its comparison with Cochrane systematic review are discussed in detail. Researchers should not only conduct Cochrane systematic reviews to investigate the effectiveness of interventions, but also consider realist review to explain the causal mechanism underneath complex interventions so as to provide more contextual recommendations for clinical practice.
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Realist review: a theory-driven systematic review of complex interventionsunder realism philosophy
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