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Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity.

ABSTRACT: A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an 'equity lens' to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and apply an equity lens by developing a knowledge translation product comprising summaries of systematic reviews from the Cochrane Library. E4E translates evidence from systematic reviews into 'friendly front end' summaries for policy makers.The following topic areas with high burdens of disease globally, were selected for the pilot: diabetes/obesity, HIV/AIDS, malaria, nutrition, and mental health/depression. For each topic area, a "stakeholder panel" was assembled that included policymakers and researchers. A systematic search of Cochrane reviews was conducted for each area to identify equity-relevant interventions with a meaningful impact. Panel chairs developed a rating sheet which was used by all panels to rank the importance of these interventions by: 1) Ease of Implementation; 2) Health System Requirements; 3)Universality/Generalizability/Share of Burden; and 4) Impact on Inequities/Effect on equity. The ratings of panel members were averaged for each intervention and criterion, and interventions were ordered according to the average overall ratings.Stakeholder panels identified the top 10 interventions from their respective topic areas. The evidence on these interventions is being summarized with an equity focus and the results posted online, at http://methods.cochrane.org/equity/e4e-series .This method provides an explicit approach to setting priorities by systematic review groups and funders for providing decision makers with evidence for the most important equity-relevant interventions.

SUBMITTER: Tugwell P

PROVIDER: S-EPMC5712153 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity.

Tugwell Peter P Petkovic Jennifer J Welch Vivian V Vincent Jennifer J Bhutta Zulfiqar A ZA Churchill Rachel R deSavigny Don D Mbuagbaw Lawrence L Pantoja Tomas T

International journal for equity in health 20171202 1

<h4>Background</h4>A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an 'equity lens' to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and a ...[more]

PMID: 29197403

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Project description:BackgroundAppropriate dissemination of public health evidence is of high importance to ensure that scientific knowledge reaches potential stakeholders and relevant population groups. A wide distrust towards science and its findings indicates that communication thereof remains below its potential. Cochrane Public Health provides an important source of high-quality scientific evidence in the field of public health via reviews with systematic methodology. The aims of this study were to identify (1) dissemination strategies and (2) stakeholders of Cochrane Public Health reviews.MethodsThis is a bibliographic study with a cross-sectional design. All 68 records (reviews or review protocols) listed on the Cochrane Public Health website ( https://ph.cochrane.org/cph-reviews-and-topics ) up to 8 March 2022 were included. Record characteristics, dissemination strategies, and potential stakeholder details were coded by one author, and 10% of records were checked by another author. Data were analyzed using descriptive statistics or narratively into common themes.ResultsThe 68 records were published between 2010 and 2022 and included 15 review protocols and 53 reviews with systematic methodology (46 systematic, 6 rapid, and 1 scoping review). All 53 reviews were disseminated via open-access plain language summaries (PLS) in English with translations into 3-13 other languages. Other dissemination strategies included information on Cochrane websites (e.g., clinical answers or guidelines) available for 41/53 reviews and Cochrane news or blogs that mentioned 19/53 reviews. Overall, 23/68 records mentioned the actual stakeholder involvement in review production, protocol development, or formulation of dissemination plans. The potential stakeholders included several highly diverse groups, such as the general population or specific communities (e.g., racial minority groups), policy and decision makers, and researchers and professionals in various fields (e.g., nutrition, physical activity, education, or care).ConclusionsThis study shows that Cochrane Public Health reviews are disseminated predominantly via PLS in different languages and via review information on Cochrane websites. Planned dissemination strategies were rarely reported although actual stakeholders were involved in the planning and production of some reviews. The relevance of Cochrane Public Health reviews for non-academic stakeholders and the general population highlights the need for the dissemination of evidence from such reviews beyond academia.Systematic review registrationThe study was prospectively registered at the Open Science Framework ( https://osf.io/ga9pt/ ).

Project description:The CHNRI method for setting health research priorities has crowdsourcing as the major component. It uses the collective opinion of a group of experts to generate, assess and prioritize between many competing health research ideas. It is difficult to compare the accuracy of human individual and collective opinions in predicting uncertain future outcomes before the outcomes are known. However, this limitation does not apply to existing knowledge, which is an important component underlying opinion. In this paper, we report several experiments to explore the quantitative properties of human collective knowledge and discuss their relevance to the CHNRI method.We conducted a series of experiments in groups of about 160 (range: 122-175) undergraduate Year 2 medical students to compare their collective knowledge to their individual knowledge. We asked them to answer 10 questions on each of the following: (i) an area in which they have a degree of expertise (undergraduate Year 1 medical curriculum); (ii) an area in which they likely have some knowledge (general knowledge); and (iii) an area in which they are not expected to have any knowledge (astronomy). We also presented them with 20 pairs of well-known celebrities and asked them to identify the older person of the pair. In all these experiments our goal was to examine how the collective answer compares to the distribution of students' individual answers.When answering the questions in their own area of expertise, the collective answer (the median) was in the top 20.83% of the most accurate individual responses; in general knowledge, it was in the top 11.93%; and in an area with no expertise, the group answer was in the top 7.02%. However, the collective answer based on mean values fared much worse, ranging from top 75.60% to top 95.91%. Also, when confronted with guessing the older of the two celebrities, the collective response was correct in 18/20 cases (90%), while the 8 most successful individuals among the students had 19/20 correct answers (95%). However, when the system in which the students who were not sure of the correct answer were allowed to either choose an award of half of the point in all such instances, or withdraw from responding, in order to improve the score of the collective, the collective was correct in 19/20 cases (95%), while the 3 most successful individuals were correct in 17/20 cases (85%).Our experiments showed that the collective knowledge of a group with expertise in the subject should always be very close to the true value. In most cases and under most assumption, the collective knowledge will be more accurate than the knowledge of an "average" individual, but there always seems to be a small group of individuals who manage to out-perform the collective. The accuracy of collective prediction may be enhanced by allowing the individuals with low confidence in their answer to withdraw from answering.

Project description:ObjectiveOsteoarthritis generates substantial health and socioeconomic burden, which is particularly marked in marginalized groups. It is imperative that practitioners have ready access to summaries of evidence-based interventions for osteoarthritis that incorporate equity considerations. Summaries of systematic reviews can provide this. The present study surveyed experts to prioritize a selection ofinterventions, from which equity focused summaries will be generated. Specifically, the prioritized interventions will be developed into Cochrane Evidence4Equity (E4E) summaries.MethodsTwenty-seven systematic reviews of OA interventions were found. From these, twenty-nine non-surgical treatments for osteoarthritis were identified, based on statistically significant findings for desired outcome variables or adverse events. Key findings from these studies were summarised and provided to 9 experts in the field of osteoarthritis.. Expert participants were asked to rate interventions based on feasibility, health system effects, universality, impact on inequities, and priority for translation into equity based E4E summaries. Expert participants were also encouraged to make comments to provide context for each rating. Free text responses were coded inductively and grouped into subthemes and themes.ResultsExpert participants rated the intervention home land-based exercise for knee OA highest for priority for translation into an E4E summaries, followed by the interventions individual land-based exercise for knee OA, class land-based exercise for knee OA, exercise for hand OA and land-based exercise for hip OA. Upon qualitative analysis of the expert participants' comments, fifteen subthemes were identified and grouped into three overall themes: (1) this intervention or an aspect of this intervention is unnecessary or unsafe; (2) this intervention or an aspect of this intervention may increase health inequities; and (3) experts noted difficulties completing rating exercise.ConclusionThe list of priority interventions and corresponding expert commentary generated information that will be used to direct and support knowledge translation efforts.

Project description:Background Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes. Methods Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised. Results Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2 =?26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES)?=?0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2 =?74.3%; PI -0.18, 0.53], MES?=?0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions. Conclusion There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns. Trial registration Registered in PROSPERO (CRD42019120295) on 10th January 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09855-3.

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Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity.

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Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity.

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