Dear All,
My congratulations to two of our email list members (Marjolein and Barend) as they have had a realist review on Access to health workers in rural and remote areas publsihed by the WHO:
http://www.who.int/hrh/resources/realist_review/en/index.html
They have kindly allowed us all to use their recent review as a 'case example' from which we might be able to learn some methdological lessons. I have had a chance to read their review in detail and to start the discussion off, I would like to pose a few questions (in no particular order of importance):
1) What do people think about how the authors have conceptualised (section 2.2.1):
a) Mechanism?
b) context?
c) the relationship between intervention and context?
2) The authors have clearly stated that they have resisted making interpretations (page 3 section 2.2.2) and drawn their analysis (Findings - section 3 onwards) from only what was reported in their included studies. What are the ADVANTAGES and DISADVANTAGES of taking such an approach?
3) I could not find any mention of middle-range theory (theories) in this review. What role does middle-range theory play and how could it have been used in this review?
4) The issue about middle-range theory brings up some wider question about the use of theory in realist reviews. For example:
a) What is a theory?
b) What types of theory are revelant to realist reviews?
c) Where do these theories come from?
d) What do we do with these theories?
e) How do we know these theories are the correct ones?
Please feel free to comment on all or some of these questions and also to add to them if you have identified further questions and/or learning points.
Please don't forget our 'ground rules' and thanks for reading and contributing.
Geoff
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