Stakeholder involvement in systematic reviews of healthcare interventions: reflections, reporting and recommendations

Systematic reviews use rigorous methods to identify, appraise and synthesise relevant studies to answer a research question. As well as being clearly reported and objective, it is important that they are clinically relevant and that the findings are applicable. Involving stakeholders in the review process, such as patients and healthcare professionals, may increase the relevance of the review and reduce the potential for research waste. Stakeholder involvement is valuable when interpreting systematic review results, putting them in context when drawing conclusions, improving applicability. Stakeholders are also well placed to help with dissemination and uptake of research findings. Much of the existing literature on stakeholder involvement in healthcare research has focused on patient and public involvement in primary research. Literature on broader stakeholder involvement in systematic reviews is relatively scarce, although guidance has recently become available through the Cochrane online learning resource ‘Involving People’, developed using the evidence base identified by the ACTIVE (Authors and Consumers Together Impacting on eVidencE) project. This thesis describes and critically appraises the stakeholder involvement methods that I have developed over a range of review topics, including preventative, therapeutic and diagnostic healthcare interventions. For consistency and transparency, I have reported my methods using the ACTIVE framework, which has yet to be widely adopted by review authors. The (modified) ACTIVE summary table demonstrates the increasing level of stakeholder involvement and influence over the course of the projects, from contribution at specific review stages to control (or co-production). I have also presented a reflection/critical perspective, as recommended in the GRIPP2 (Guidance for Reporting Involvement of Patients and Public) checklist. In order to supplement existing guidance, I have made specific recommendations for planning stakeholder involvement in systematic reviews, relating to budgeting/resources, recruitment, communication and practical considerations. These recommendations should be informative to researchers planning stakeholder involvement in systematic reviews.