Systematic reviews and knowledge translation

Abstract

Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence.We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies.We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings. Voir page 649 le résumé en français. En la página 649 figura un resumen en español.

The Environmental Millennium Development Goal: progress and barriers to its achievement

“…We identified less information for MDG7 than for the other MDGs. However, scientific knowledge is fundamental for the design of further interventions to achieve the Millennium Development Goals (Tugwell et al, 2006) and could identify structural or social problems that prevent the achievement of this macro agreement and future agreements.…”

Investigating clinical heterogeneity in systematic reviews: a methodologic review of guidance in the literature

“…As such, systematic reviewers need to consider how best to handle sources of heterogeneity [1]. For example, preplanned subgroup analyses, stratifying for similar characteristics of the intervention and participants, could tease-out important scientific and clinically relevant information [3]. Systematic reviews are frequently recognized as the best available evidence for decisions about health-care management and policy [3][4][5][6][7].…”

“…For example, preplanned subgroup analyses, stratifying for similar characteristics of the intervention and participants, could tease-out important scientific and clinically relevant information [3]. Systematic reviews are frequently recognized as the best available evidence for decisions about health-care management and policy [3][4][5][6][7]. Results of systematic reviews are often incorporated into clinical practice guidelines [5] and required in funding applications by granting agencies [6].…”

Knowledge‐for‐action theories in evaluation: Knowledge utilization, diffusion, implementation, transfer, and translation

“…With roots in applied linguistics and communication, knowledge translation is a transdisciplinary, multilevel knowledge-for-action theory. In the recent explosion of knowledge translation literature (Tugwell, Robinson, Grimshaw, & Santesso, 2006), translation has been conceptualized as the practice, science, and art of bridging the "know-do gap" between knowledge accumulation and use (World Health Organization, 2006). The what that moves in knowledge translation is research products or synthesis (see Table 1.1).…”