The Oxford Implementation Index: A new tool for incorporating implementation data into systematic reviews and meta-analyses

Paul Montgomery, Kristen Underhill, Frances Gardner, Don Operario, Evan Mayo-Wilson

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Objectives: This article presents a new tool that helps systematic reviewers to extract and compare implementation data across primary trials. Currently, systematic review guidance does not provide guidelines for the identification and extraction of data related to the implementation of the underlying interventions. Study Design and Setting: A team of systematic reviewers used a multistaged consensus development approach to develop this tool. First, a systematic literature search on the implementation and synthesis of clinical trial evidence was performed. The team then met in a series of subcommittees to develop an initial draft index. Drafts were presented at several research conferences and circulated to methodological experts in various health-related disciplines for feedback. The team systematically recorded, discussed, and incorporated all feedback into further revisions. A penultimate draft was discussed at the 2010 Cochrane-Campbell Collaboration Colloquium to finalize its content. Results: The Oxford Implementation Index provides a checklist of implementation data to extract from primary trials. Checklist items are organized into four domains: intervention design, actual delivery by trial practitioners, uptake of the intervention by participants, and contextual factors. Systematic reviewers piloting the index at the Cochrane-Campbell Colloquium reported that the index was helpful for the identification of implementation data. Conclusion: The Oxford Implementation Index provides a framework to help reviewers assess implementation data across trials. Reviewers can use this tool to identify implementation data, extract relevant information, and compare features of implementation across primary trials in a systematic review. The index is a work-in-progress, and future efforts will focus on refining the index, improving usability, and integrating the index with other guidance on systematic reviewing.

Original languageEnglish (US)
Pages (from-to)874-882
Number of pages9
JournalJournal of Clinical Epidemiology
Issue number8
StatePublished - Aug 2013
Externally publishedYes


  • Generalizability
  • Heterogeneity
  • Implementation
  • Randomized controlled trial
  • Reporting guideline
  • Systematic review

ASJC Scopus subject areas

  • Epidemiology


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