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

Abstract

BackgroundA 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.MethodsThe 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.ResultsStakeholder 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.ConclusionsThis 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.Electronic supplementary materialThe online version of this article (10.1186/s12939-017-0697-5) contains supplementary material, which is available to authorized users.

Experts Prioritize Osteoarthritis Non-Surgical Interventions From Cochrane Systematic Reviews for Translation Into “Evidence4Equity” Summaries.

“…This priority-setting exercise was modeled from those previously used to complete E4E summaries on depression, diabetes and obesity, HIV/AIDS, malaria, and nutrition [31]. In order to identify relevant interventions for the survey, we conducted a search for systematic reviews of osteoarthritis treatments published in Cochrane Library from 2011-2018 using the search terms 'osteoarthritis' or 'musculoskeletal'.…”

“…Respondents were asked to rate each intervention on ve criteria, using a Likert scale (0-4). Criteria where chosen based on methodology from previous E4E projects [31]. Criteria were as follows;…”

“…This priority-setting exercise was modeled from those previously used to complete E4E summaries on depression, diabetes and obesity, HIV/AIDS, malaria, and nutrition [30,31]. Fourteen physicians, policy makers and research experts in the eld of OA were identi ed and approached to participate in the study.…”

“…Mean ratings on all ve criteria for each of the interventions were generated (see Table 1). Consistent with previous E4E methodology [31], these ratings were converted to a score out of 100 for easier interpretations by reviewers (scores were divided by 4 and multiplied by 100). In order to further elucidate which criteria in uenced the experts' 'overall' score, Pearson correlation values were calculated for each of the four equity-based criteria ('ease of implementation', 'health system requirements', 'universality', and 'impact on inequities') using Excel.…”

“…To this end, the E4E initiative was developed to prioritize and translate this enormous volume of systematic reviews into user-friendly summaries to improve access and applicability of relevant interventions for disadvantaged populations [30]. E4E priority-setting exercises have already been applied to Cochrane reviews of depression, diabetes and obesity, HIV/AIDS, malaria, and nutrition [31]. Thus far, there has been no E4E summary of Cochrane reviews on osteoarthritis to direct equitable decision making among policy makers and health practitioners.…”