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Table 2 Summary of optional dimensions and assessment criteria for the iCAT_SR

From: Assessing the complexity of interventions within systematic reviews: development, content and use of a new tool (iCAT_SR)

Optional dimension Assessment levels and criteria for each dimension
7. The degree of interaction between intervention components, including the independence/interdependence of intervention components High level interaction There is substantial interaction or inter-dependency between intervention components or actions i.e. the delivery of one intervention component impacts on the delivery of another, resulting in a synergistic effect.
Moderate interaction There is some degree of interaction but no evidence of synergistic effects or dysynergistic effects.
Independent The intervention has only one component or action, or the components act independently.
Varies a Varies across interventions to be considered for/included in the review.
Unclear or unable to assess
8. The degree to which the effects of the intervention are dependent on the context or setting in which it is implemented Highly context dependent The effects of the intervention are likely to be strongly dependent on the implementation setting.
Moderately context dependent The effects of the intervention are likely to be transferrable across a limited range of settings only (e.g. only within a specific country or health system).
Independent of context The effects of the intervention do not appear to be strongly dependent on the implementation setting, i.e. it is anticipated that the effects of the intervention will be similar across a wide range of contexts or settings.
Varies a Varies across interventions to be considered for/included in the review.
Unclear or unable to assess
9. The degree to which the effects of the intervention are changed by recipient or provider factors Highly dependent on individual-level factors The effects of the intervention are modified by both recipient and provider factors.
Moderately dependent on individual-level factors The effects of the intervention are modified by one of recipient or provider factors.
Largely independent of individual-level factors The effects of the intervention are not modified substantially by recipient or provider factors.
Varies a Varies across interventions to be considered for/included in the review.
Unclear or unable to assess
10. The nature of the causal pathway between the intervention and the outcome it is intended to effect Pathway variable, long The causal pathway includes three or more steps between intervention and outcome or occurs over a long time period; is not linear, or is variable; and/or more than one causal pathway has been proposed.
Pathway linear, long The causal pathway is linear but there are three or more steps between intervention and outcome.
Pathway linear, short The causal pathway is clear, short (only one or two steps), direct, linear.
Varies a Varies across interventions to be considered for/included in the review.
Unclear or unable to assess
  1. aIf this category is selected, review authors should consider whether the interventions included in the review are as similar as originally thought and whether this has implications for the review’s inclusion criteria