Introduction to ACTIVE framework to describe stakeholder involvement in systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

HU Zhiqiao ¹ , WANG Liao ² ,  LIU Chang ² ,  FANG Hongzhi ¹

1. Department of Stomatology, the Third People’s Hospital of Chengdu, Chengdu 610031, P. R. China;
2. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LIU Chang, Email: 1127958575@qq.com; FANG Hongzhi, Email: 1127958575@qq.com

Keywords：

Systematic review; Evidence synthesis; ACTIVE framework; Stakeholder involvement

DOI：

10.7507/1672-2531.202601003

Video：

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Objective This study elucidates the ACTIVE framework, a structured descriptive tool for stakeholder involvement in systematic reviews, summarizing its core elements and applicable scenarios to provide methodological references for domestic researchers. Methods Through literature analysis, this study systematically examines the development process of the ACTIVE framework, its constituent elements, and practical case studies, while analyzing its actual application in systematic reviews. Results The ACTIVE framework tool consists of five core elements: participant identity, recruitment methods, engagement models, participation stages, and degree of involvement. This framework significantly enhances its operability as a guiding tool through systematic and structured descriptive approaches. Conclusion The ACTIVE framework is the first structured tool specifically designed to describe stakeholder engagement in systematic reviews. Its widespread application will facilitate more standardized and transparent implementation of stakeholder involvement by systematic review authors in practice.

Citation： HU Zhiqiao, WANG Liao, LIU Chang, FANG Hongzhi. Introduction to ACTIVE framework to describe stakeholder involvement in systematic reviews. Chinese Journal of Evidence-Based Medicine, 2026, 26(9): 1095-1102. doi: 10.7507/1672-2531.202601003 Copy

1.	Pollock A, Campbell P, Struthers C, et al. Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews[J]. J Health Serv Res Policy, 2019, 24(4): 245-255.
2.	李輝, 謝雪微. CONSORT 2025聲明解讀: 患者及公眾參與說明[J]. 中國卒中雜志, 2025, 20(5): 630-635.
3.	Haddaway RN, Kohl C, Silva DRN, et al. A framework for stakeholder engagement during systematic reviews and maps in environmental management[J]. Environ Evid, 2017, 6(1): 1-14.
4.	Petkovic J, Khabsa J, Lytvyn L, et al. Introducing a series of reviews assessing engagement in evidence syntheses[J]. Cochrane Evid Synth Methods, 2025, 3(6): e70057.
5.	高一城, 夏如玉, 羅慜婧, 等. 國內外臨床實踐指南制訂手冊中關于患者參與要求的系統評價[J]. 中國循證醫學雜志, 2022, 22(10): 1182-1188.
6.	吳沛霞, 胡雁. 患者和公眾參與研究的報告規范(GRIPP 2)解讀[J]. 中國循證醫學雜志, 2018, 18(1): 96-100.
7.	Alex P, Pauline C, Caroline S, et al. Stakeholder involvement in systematic reviews: a scoping review[J]. Syst Rev, 2018, 7(1): 208.
8.	Concannon TW, Fuster M, Saunders T, et al. A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research[J]. J Gen Intern Med, 2014, 29(12): 1692-1701.
9.	McCarron TL, Noseworthy T, Moffat K, et al. A co-designed framework to support and sustain patient and family engagement in health-care decision making[J]. Health Expect, 2020, 23(4): 825-836.
10.	Westerink HJ, Oirbans T, Garvelink MM, et al. Barriers and facilitators of meaningful patient participation at the collective level in healthcare organizations: a systematic review[J]. Health Policy, 2023, 138: 104946.
11.	Cluley V, Ziemann A, Feeley C, et al. Mapping the role of patient and public involvement during the different stages of healthcare innovation: a scoping review[J]. Health Expect, 2022, 25(3): 840-855.
12.	Totzeck C, van der Meer AS, Christiansen H, et al. Systematic review: patient and public involvement of children and young people in mental health research[J]. Clin Child Fam Psychol Rev, 2024, 27(1): 257-274.
13.	Guidelines International Network. G-I-N public toolkit: patient and public involvement in guidelines[Z]. 2015.
14.	Baines R, Bradwell H, Edwards K, et al. Meaningful patient and public involvement in digital health innovation, implementation and evaluation: a systematic review[J]. Health Expect, 2022, 25(4): 1232-1245.
15.	Owyang D, Bakhsh A, Brewer D, et al. Patient and public involvement within orthopaedic research: a systematic review[J]. J Bone Joint Surg Am, 2021, 103(13): e51.
16.	Bond KS, Chalmers KJ, Jorm AF, et al. Assisting Australians with mental health problems and financial difficulties: a Delphi study to develop guidelines for financial counsellors, financial institution staff, mental health professionals and carers[J]. BMC Health Serv Res, 2015, 15: 218.
17.	Boelens PG, Taylor C, Henning G, et al. Involving patients in a multidisciplinary European consensus process and in the development of a 'patient summary of the consensus document for colon and rectal cancer care'[J]. Patient, 2014, 7(3): 261-270.
18.	Hyde C, Dunn KM, Higginbottom A, et al. Process and impact of patient involvement in a systematic review of shared decision making in primary care consultations[J]. Health Expect, 2017, 20(2): 298-308.
19.	Brown J, Baer G, Cameron S, et al. Stakeholder involvement in a Cochrane review of physical rehabilitation after stroke: description and reflections[J]. Cochrane Evid Synth Methods, 2023, 1(10): e12032.
20.	Staniszewska S, Brett J, Simera I, et al. GRIPP2 reporting checklists: tools to improve reporting of patient and public involvement in research[J]. Res Involv Engagem, 2017, 3: 13.
21.	Andersen MZ, Zeinert P, Rosenberg J, et al. Comparative analysis of Cochrane and non-Cochrane reviews over three decades[J]. Syst Rev, 2024, 13(1): 120.
22.	Hickey G, Brearley S, Coldham, et al. Guidance on coproducing a research project[Z]. Southampton: NIHR INVOLVE, 2018.
23.	Greenhalgh T, Hinton L, Finlay T, et al. Frameworks for supporting patient and public involvement in research: systematic review and co-design pilot[J]. Health Expect, 2019, 22(4): 785-801.
24.	Musbahi A, Clyde D, Small P, et al. A systematic review of patient and public involvement (PPI) in bariatric research trials: the need for more work[J]. Obes Surg, 2022, 32(11): 3740-3751.
25.	Agyei-Manu E, Atkins N, Lee B, et al. The benefits, challenges, and best practice for patient and public involvement in evidence synthesis: a systematic review and thematic synthesis[J]. Health Expect, 2023, 26(4): 1436-1452.
26.	McGrath C, Davies SR, Ali I, et al. Public involvement in a systematic review project: reporting our approach using the ACTIVE framework[J]. Health Expect, 2025, 28(4): e70323.
27.	Hoosain M, Plastow NA. Workplace-based occupational therapy for mental health in Africa: a scoping review protocol[J]. BMJ Open, 2022, 12(4): e054821.

1. Pollock A, Campbell P, Struthers C, et al. Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews[J]. J Health Serv Res Policy, 2019, 24(4): 245-255.
2. 李輝, 謝雪微. CONSORT 2025聲明解讀: 患者及公眾參與說明[J]. 中國卒中雜志, 2025, 20(5): 630-635.
3. Haddaway RN, Kohl C, Silva DRN, et al. A framework for stakeholder engagement during systematic reviews and maps in environmental management[J]. Environ Evid, 2017, 6(1): 1-14.
4. Petkovic J, Khabsa J, Lytvyn L, et al. Introducing a series of reviews assessing engagement in evidence syntheses[J]. Cochrane Evid Synth Methods, 2025, 3(6): e70057.
5. 高一城, 夏如玉, 羅慜婧, 等. 國內外臨床實踐指南制訂手冊中關于患者參與要求的系統評價[J]. 中國循證醫學雜志, 2022, 22(10): 1182-1188.
6. 吳沛霞, 胡雁. 患者和公眾參與研究的報告規范(GRIPP 2)解讀[J]. 中國循證醫學雜志, 2018, 18(1): 96-100.
7. Alex P, Pauline C, Caroline S, et al. Stakeholder involvement in systematic reviews: a scoping review[J]. Syst Rev, 2018, 7(1): 208.
8. Concannon TW, Fuster M, Saunders T, et al. A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research[J]. J Gen Intern Med, 2014, 29(12): 1692-1701.
9. McCarron TL, Noseworthy T, Moffat K, et al. A co-designed framework to support and sustain patient and family engagement in health-care decision making[J]. Health Expect, 2020, 23(4): 825-836.
10. Westerink HJ, Oirbans T, Garvelink MM, et al. Barriers and facilitators of meaningful patient participation at the collective level in healthcare organizations: a systematic review[J]. Health Policy, 2023, 138: 104946.
11. Cluley V, Ziemann A, Feeley C, et al. Mapping the role of patient and public involvement during the different stages of healthcare innovation: a scoping review[J]. Health Expect, 2022, 25(3): 840-855.
12. Totzeck C, van der Meer AS, Christiansen H, et al. Systematic review: patient and public involvement of children and young people in mental health research[J]. Clin Child Fam Psychol Rev, 2024, 27(1): 257-274.
13. Guidelines International Network. G-I-N public toolkit: patient and public involvement in guidelines[Z]. 2015.
14. Baines R, Bradwell H, Edwards K, et al. Meaningful patient and public involvement in digital health innovation, implementation and evaluation: a systematic review[J]. Health Expect, 2022, 25(4): 1232-1245.
15. Owyang D, Bakhsh A, Brewer D, et al. Patient and public involvement within orthopaedic research: a systematic review[J]. J Bone Joint Surg Am, 2021, 103(13): e51.
16. Bond KS, Chalmers KJ, Jorm AF, et al. Assisting Australians with mental health problems and financial difficulties: a Delphi study to develop guidelines for financial counsellors, financial institution staff, mental health professionals and carers[J]. BMC Health Serv Res, 2015, 15: 218.
17. Boelens PG, Taylor C, Henning G, et al. Involving patients in a multidisciplinary European consensus process and in the development of a 'patient summary of the consensus document for colon and rectal cancer care'[J]. Patient, 2014, 7(3): 261-270.
18. Hyde C, Dunn KM, Higginbottom A, et al. Process and impact of patient involvement in a systematic review of shared decision making in primary care consultations[J]. Health Expect, 2017, 20(2): 298-308.
19. Brown J, Baer G, Cameron S, et al. Stakeholder involvement in a Cochrane review of physical rehabilitation after stroke: description and reflections[J]. Cochrane Evid Synth Methods, 2023, 1(10): e12032.
20. Staniszewska S, Brett J, Simera I, et al. GRIPP2 reporting checklists: tools to improve reporting of patient and public involvement in research[J]. Res Involv Engagem, 2017, 3: 13.
21. Andersen MZ, Zeinert P, Rosenberg J, et al. Comparative analysis of Cochrane and non-Cochrane reviews over three decades[J]. Syst Rev, 2024, 13(1): 120.
22. Hickey G, Brearley S, Coldham, et al. Guidance on coproducing a research project[Z]. Southampton: NIHR INVOLVE, 2018.
23. Greenhalgh T, Hinton L, Finlay T, et al. Frameworks for supporting patient and public involvement in research: systematic review and co-design pilot[J]. Health Expect, 2019, 22(4): 785-801.
24. Musbahi A, Clyde D, Small P, et al. A systematic review of patient and public involvement (PPI) in bariatric research trials: the need for more work[J]. Obes Surg, 2022, 32(11): 3740-3751.
25. Agyei-Manu E, Atkins N, Lee B, et al. The benefits, challenges, and best practice for patient and public involvement in evidence synthesis: a systematic review and thematic synthesis[J]. Health Expect, 2023, 26(4): 1436-1452.
26. McGrath C, Davies SR, Ali I, et al. Public involvement in a systematic review project: reporting our approach using the ACTIVE framework[J]. Health Expect, 2025, 28(4): e70323.
27. Hoosain M, Plastow NA. Workplace-based occupational therapy for mental health in Africa: a scoping review protocol[J]. BMJ Open, 2022, 12(4): e054821.

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Introduction to ACTIVE framework to describe stakeholder involvement in systematic reviews

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