Maximizing the Impact of Systematic Reviews in Health Care Decision Making: A Systematic Scoping Review of Knowledge-Translation Resources

Chambers, Duncan; Wilson, Paul; Thompson, Carl; Hanbury, Andria; Farley, Katherine; Light, Kate

doi:10.1111/j.1468-0009.2011.00622.x

Cited by 69 publications

(71 citation statements)

References 18 publications

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“…The availability of a systematic review alone does not ensure that decision makers know it is available to them or can interpret the findings or use the evidence in service delivery decisions [38]. Further evaluations of these resources are needed to ensure users' needs and preferences are being met, to demonstrate their impact, justify their funding [39,40] and ensure the relevance and applicability of the results to the practice setting [41]. …”

Section: Discussionmentioning

confidence: 99%

The effectiveness of knowledge translation strategies used in public health: a systematic review

et al. 2012

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BackgroundLiterature related to the effectiveness of knowledge translation (KT) strategies used in public health is lacking. The capacity to seek, analyze, and synthesize evidence-based information in public health is linked to greater success in making policy choices that have the best potential to yield positive outcomes for populations. The purpose of this systematic review is to identify the effectiveness of KT strategies used to promote evidence-informed decision making (EIDM) among public health decision makers.MethodsA search strategy was developed to identify primary studies published between 2000–2010. Studies were obtained from multiple electronic databases (CINAHL, Medline, EMBASE, and the Cochrane Database of Systematic Reviews). Searches were supplemented by hand searching and checking the reference lists of included articles. Two independent review authors screened studies for relevance, assessed methodological quality of relevant studies, and extracted data from studies using standardized tools.ResultsAfter removal of duplicates, the search identified 64, 391 titles related to KT strategies. Following title and abstract review, 346 publications were deemed potentially relevant, of which 5 met all relevance criteria on full text screen. The included publications were of moderate quality and consisted of five primary studies (four randomized controlled trials and one interrupted time series analysis). Results were synthesized narratively. Simple or single KT strategies were shown in some circumstances to be as effective as complex, multifaceted ones when changing practice including tailored and targeted messaging. Multifaceted KT strategies led to changes in knowledge but not practice. Knowledge translation strategies shown to be less effective were passive and included access to registries of pre-processed research evidence or print materials. While knowledge brokering did not have a significant effect generally, results suggested that it did have a positive effect on those organizations that at baseline perceived their organization to place little value on evidence-informed decision making.ConclusionsNo singular KT strategy was shown to be effective in all contexts. Conclusions about interventions cannot be taken on their own without considering the characteristics of the knowledge that was being transferred, providers, participants and organizations.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of knowledge translation strategies used in public health: a systematic review

et al. 2012

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“…The search identified six related studies: three systematic reviews [3], [24], [25], two randomised controlled trials [5], [26] and one qualitative study [15]. Only one [26] of the studies was conducted in a guideline development context.…”

Section: Discussionmentioning

confidence: 99%

“…Only one [26] of the studies was conducted in a guideline development context. The systematic reviews noted that presentation of results of systematic reviews [3], [24] and health technology assessments [25] using ‘graded-entry’ formats (e.g. one page take home messages, a three-page executive summary and a 25-page report, 1∶3:25 format) rendered them more useful to healthcare managers and policymakers.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Alternative Evidence Summary and Presentation Formats in Clinical Guideline Development: A Mixed-Method Study

et al. 2013

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BackgroundBest formats for summarising and presenting evidence for use in clinical guideline development remain less well defined. We aimed to assess the effectiveness of different evidence summary formats to address this gap.MethodsHealthcare professionals attending a one-week Kenyan, national guideline development workshop were randomly allocated to receive evidence packaged in three different formats: systematic reviews (SRs) alone, systematic reviews with summary-of-findings tables, and ‘graded-entry’ formats (a ‘front-end’ summary and a contextually framed narrative report plus the SR). The influence of format on the proportion of correct responses to key clinical questions, the primary outcome, was assessed using a written test. The secondary outcome was a composite endpoint, measured on a 5-point scale, of the clarity of presentation and ease of locating the quality of evidence for critical neonatal outcomes. Interviews conducted within two months following completion of trial data collection explored panel members’ views on the evidence summary formats and experiences with appraisal and use of research information.Results65 (93%) of 70 participants completed questions on the prespecified outcome measures. There were no differences between groups in the odds of correct responses to key clinical questions. ‘Graded-entry’ formats were associated with a higher mean composite score for clarity and accessibility of information about the quality of evidence for critical neonatal outcomes compared to systematic reviews alone (adjusted mean difference 0.52, 95% CI 0.06 to 0.99). There was no difference in the mean composite score between SR with SoF tables and SR alone. Findings from interviews with 16 panelists indicated that short narrative evidence reports were preferred for the improved clarity of information presentation and ease of use.ConclusionsOur findings suggest that ‘graded-entry’ evidence summary formats may improve clarity and accessibility of research evidence in clinical guideline development.Trial RegistrationControlled-Trials.com ISRCTN05154264

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“…Development of the service was informed by a scoping review of existing resources, 25 previous CRD experience in producing and disseminating the internationally renowned Effective Health Care and Effectiveness Matters series of bulletins and initial iterative interactions with decision-makers on a range of mental health topics. We sought to address a number of known content, format and communication barriers to research use.…”

Section: Chapter 1 Contextmentioning

confidence: 99%

“…15 As part of our developmental work we conducted a systematic review of products and services aimed at making the results of systematic reviews more accessible to health-care decision-makers. 25 This highlighted a lack of formal evaluation in the field. Indeed, most identified evaluations focused on perceived usefulness of products and services and not on actual impact.…”

Section: Chapter 1 Contextmentioning

confidence: 99%

Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services: a controlled before-and-after study

Wilson

Farley

Bickerdike

et al. 2017

Health Serv Deliv Res

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BackgroundThe Health and Social Care Act 2012 (Great Britain.Health and Social Care Act 2012. London: The Stationery Office; 2012) has mandated research use as a core consideration of health service commissioning arrangements. We evaluated whether or not access to a demand-led evidence briefing service improved the use of research evidence by commissioners, compared with less intensive and less targeted alternatives.DesignControlled before-and-after study.SettingClinical Commissioning Groups (CCGs) in the north of England.Main outcome measuresChange at 12 months from baseline of a CCG’s ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes measured individual clinical leads’ and managers’ intentions to use research evidence in decision-making.MethodsNine CCGs received one of three interventions: (1) access to an evidence briefing service; (2) contact plus an unsolicited push of non-tailored evidence; or (3) an unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months post intervention, using a survey instrument devised to assess an organisation’s ability to acquire, assess, adapt and apply research evidence to support decision-making. In addition, documentary and observational evidence of the use of the outputs of the service was sought and interviews with CCG participants were undertaken.ResultsMost of the requests were conceptual; they were not directly linked to discrete decisions or actions but were intended to provide knowledge about possible options for future actions. Symbolic use to justify existing decisions and actions were less frequent and included a decision to close a walk-in centre and to lend weight to a major initiative to promote self-care already under way. The opportunity to impact directly on decision-making processes was limited to work to establish disinvestment policies. In terms of impact overall, the evidence briefing service was not associated with increases in CCGs’ capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCGs’ relationships with researchers. Regardless of the intervention received, at baseline participating CCGs indicated that they felt that they were inconsistent in their research-seeking behaviours and their capacity to acquire research remained so at follow-up. The informal nature of decision-making processes meant that there was little or no traceability of the use of evidence.LimitationsLow baseline and follow-up response rates (of 68% and 44%, respectively) and missing data limit the reliability of these findings.ConclusionsAccess to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear to be well intentioned but ad hoc users of research.Future workFurther research is required on the effects of interventions and strategies to build individual and organisational capacity to use research. Resource-intensive approaches to providing evidence may best be employed to support instrumental decision-making. Comparative evaluation of the impact of less intensive but targeted strategies on the uptake and use of research by commissioners is warranted.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Maximizing the Impact of Systematic Reviews in Health Care Decision Making: A Systematic Scoping Review of Knowledge-Translation Resources

Cited by 69 publications

References 18 publications

The effectiveness of knowledge translation strategies used in public health: a systematic review

The effectiveness of knowledge translation strategies used in public health: a systematic review

Comparison of Alternative Evidence Summary and Presentation Formats in Clinical Guideline Development: A Mixed-Method Study

Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services: a controlled before-and-after study

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