The multiphase optimization strategy in healthcare research: a scoping review of applications and a proposed preliminary phase-specific reporting checklist.

BACKGROUND

The multiphase optimization strategy is employed to develop multi-component interventions that strike a balance between effectiveness, affordability, scalability, and efficiency. Detailed reporting is crucial for enhancing the rigor and reproducibility of the research within healthcare. However, checklists for the optimization and evaluation phases have not yet been developed.

PURPOSE: To examine the range and identify the gap in the application of the multiphase optimization strategy.

METHODS

This scoping review was conducted across 16 online databases and related websites to locate studies published in English and Chinese before 14 May 2025. The pertinent information was extracted and synthesized by data-charting form.

RESULTS

159 papers met the inclusion criteria. Most papers focused on optimizing evidence-based practices (n = 138) rather than on implementation strategies (n = 21). In phase 1, 45.3% of studies did not report a conceptual model or did not depict it in a figure. One hundred and forty-six papers did not define optimization constraints, and 151 papers did not describe how constraints were determined. Similarly, 104 papers did not define the optimization objective or explain how it was established. In phase 2, the decision processes for selecting the optimal component were not described in 117 papers. A preliminary phase-specific reporting checklist was proposed.

CONCLUSIONS

The review reveals that many studies conflate "optimal" with "best," leading to under-specification of the optimization objectives and constraints and, consequently, to unclear decision rules for selecting components. It also reveals the need for a rigorous report of each phase for future research.