Making the Most of What We Already Know

2016 ◽  
Vol 41 (2) ◽  
pp. 155-172 ◽  
Author(s):  
Natalie Rebelo Da Silva ◽  
Hazel Zaranyika ◽  
Laurenz Langer ◽  
Nicola Randall ◽  
Evans Muchiri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Policy ◽  
Smallholder Farmers ◽  
Research Question ◽  
Evidence Base ◽  
Topic Area ◽  
Review Team ◽  
Meaningful Engagement ◽  
Key Policy ◽  
Alternative Approaches

Background: Conducting a systematic review in social policy is a resource-intensive process in terms of time and funds. It is thus important to understand the scope of the evidence base of a topic area prior to conducting a synthesis of primary research in order to maximize these resources. One approach to conserving resources is to map out the available evidence prior to undertaking a traditional synthesis. A few examples of this approach exist in the form of gap maps, overviews of reviews, and systematic maps supported by social policy and systematic review agencies alike. Despite this growing call for alternative approaches to systematic reviews, it is still common for systematic review teams to embark on a traditional in-depth review only. Objectives: This article describes a three-stage approach to systematic reviewing that was applied to a systematic review focusing in interventions for smallholder farmers in Africa. We argue that this approach proved useful in helping us to understand the evidence base. Results: By applying preliminary steps as part of a three-stage approach, we were able to maximize the resources needed to conduct a traditional systematic review on a more focused research question. This enabled us to identify and fill real knowledge gaps, build on work that had already been done, and avoid wasting resources on areas of work that would have no useful outcome. It also facilitated meaningful engagement between the review team and our key policy stakeholders.

scholarly journals Calcium silicate as a graft material for bone fractures: a systematic review

2018 ◽  
Vol 46 (7) ◽  
pp. 2537-2548 ◽  
Author(s):  
Marcelo Sanmartin de Almeida ◽  
Gustavo Vicentis de Oliveira Fernandes ◽  
Aline Muniz de Oliveira ◽  
José Mauro Granjeiro
Keyword(s):  
Systematic Review ◽  
Bone Graft ◽  
Calcium Silicate ◽  
Bone Fractures ◽  
Research Question ◽  
Evidence Base ◽  
Autogenous Bone ◽  
Graft Material ◽  
Bone Graft Material ◽  
Initial Research

Objective The goal of this review was to determine whether calcium silicate (wollastonite) as a bone graft material is a viable alternative to autogenous bone or whether the evidence base for its use is weak. Methods In this systematic review, electronic databases (MEDLINE/PubMed and BVS) were searched for relevant articles in indexed journals. Articles published in a 10-year period were identified (n = 48). After initial selection, 17 articles were assessed for eligibility; subsequently, seven articles were excluded and 10 articles were included. Results Among the studies included, 20% emphasized the importance of randomization, which adds reliability to the study, minimizing the risk of bias. High variability was observed in the material used, such as additives, amounts, dosage, and chemical alterations, rendering direct comparison among these studies impossible. The experimental periods varied considerably; one of the studies did not include statistical analysis, weakening the evaluation. Nonetheless, the true potential of wollastonite as a graft material conducive to new bone formation was reported in all studies. Conclusion The results support the use of wollastonite as a bone graft material. The initial research question was answered despite the significant variability observed among these preclinical studies, which hindered the precision of this analysis.

scholarly journals Use of a search summary table to improve systematic review search methods, results, and efficiency

2021 ◽  
Vol 109 (1) ◽  
Author(s):  
Alison C. Bethel ◽  
Morwenna Rogers ◽  
Rebecca Abbott
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Research Question ◽  
Evidence Base ◽  
Search Methods ◽  
Summary Table ◽  
Recent Systematic Review ◽  
Search Results ◽  
Simple Format

Background: Systematic reviews are comprehensive, robust, inclusive, transparent, and reproducible when bringing together the evidence to answer a research question. Various guidelines provide recommendations on the expertise required to conduct a systematic review, where and how to search for literature, and what should be reported in the published review. However, the finer details of the search results are not typically reported to allow the search methods or search efficiency to be evaluated.Case Presentation: This case study presents a search summary table, containing the details of which databases were searched, which supplementary search methods were used, and where the included articles were found. It was developed and published alongside a recent systematic review. This simple format can be used in future systematic reviews to improve search results reporting.Conclusions: Publishing a search summary table in all systematic reviews would add to the growing evidence base about information retrieval, which would help in determining which databases to search for which type of review (in terms of either topic or scope), what supplementary search methods are most effective, what type of literature is being included, and where it is found. It would also provide evidence for future searching and search methods research.

Application of Theory in Studies of Healthcare Built Environment Research

2020 ◽  
Vol 13 (3) ◽  
pp. 154-170 ◽  
Author(s):  
Michelle M. Shannon ◽  
S. Nordin ◽  
J. Bernhardt ◽  
M. Elf
Keyword(s):  
Built Environment ◽  
Research Question ◽  
Healthcare Setting ◽  
Evidence Base ◽  
Environment Design ◽  
Healthcare Facilities ◽  
Review Team ◽  
Theory Application ◽  
The Right ◽  
The Impact

We aimed to examine the nature and extent of theory application in studies of built environment attributes and impact on adults in healthcare facilities. Many varied theories are described when providing the rationale for research into built environments in healthcare. Uncertainty exists around the right theory to frame a research question, alignment with measurement tools, and whether healthcare setting makes a difference. This poses challenges to researchers seeking to build the evidence base for built environment design that benefits patients and staff. Our multidisciplinary review team scoped the literature to determine how theories are used to inform research investigating the impact of the built environment of healthcare on adults. When researchers recorded theory at development of the study question, in data collection, and in data analysis/interpretation, we called this explicitly theory-based application. Synthesis occurred using a narrative approach. Overall, we found 17 diverse theories named in studies. Explicitly theory-based use occurred with eight theories, comprising 47% of all theories used. Five theories were named more frequently in studies out of all theories identified. In 20% of studies, theory was not used explicitly during the research inquiry. We argue that researchers must continue to strive toward explicit use of theories, similar to development of other health interventions that employ multifactorial components.

scholarly journals What is the evidence for the effectiveness, appropriateness and feasibility of group clinics for patients with chronic conditions? A systematic review

2015 ◽  
Vol 3 (46) ◽  
pp. 1-194 ◽  
Author(s):  
Andrew Booth ◽  
Anna Cantrell ◽  
Louise Preston ◽  
Duncan Chambers ◽  
Elizabeth Goyder
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Health Services ◽  
Quality Assessment ◽  
Systematic Reviews ◽  
Evidence Base ◽  
Qualitative Studies ◽  
Rapid Review ◽  
Review Team ◽  
Disease Specific

BackgroundGroup clinics are a form of delivering specialist-led care in groups rather than in individual consultations.ObjectiveTo examine the evidence for the use of group clinics for patients with chronic health conditions.DesignA systematic review of evidence from randomised controlled trials (RCTs) supplemented by qualitative studies, cost studies and UK initiatives.Data sourcesWe searched MEDLINE, EMBASE, The Cochrane Library, Web of Science and Cumulative Index to Nursing and Allied Health Literature from 1999 to 2014. Systematic reviews and RCTs were eligible for inclusion. Additional searches were performed to identify qualitative studies, studies reporting costs and evidence specific to UK settings.Review methodsData were extracted for all included systematic reviews, RCTs and qualitative studies using a standardised form. Quality assessment was performed for systematic reviews, RCTs and qualitative studies. UK studies were included regardless of the quality or level of reporting. Tabulation of the extracted data informed a narrative synthesis. We did not attempt to synthesise quantitative data through formal meta-analysis. However, given the predominance of studies of group clinics for diabetes, using common biomedical outcomes, this subset was subject to quantitative analysis.ResultsThirteen systematic reviews and 22 RCT studies met the inclusion criteria. These were supplemented by 12 qualitative papers (10 studies), four surveys and eight papers examining costs. Thirteen papers reported on 12 UK initiatives. With 82 papers covering 69 different studies, this constituted the most comprehensive coverage of the evidence base to date. Disease-specific outcomes – the large majority of RCTs examined group clinic approaches to diabetes. Other conditions included hypertension/heart failure and neuromuscular conditions. The most commonly measured outcomes for diabetes were glycated haemoglobin A1c(HbA1c), blood pressure and cholesterol. Group clinic approaches improved HbA1cand improved systolic blood pressure but did not improve low-density lipoprotein cholesterol. A significant effect was found for disease-specific quality of life in a few studies. No other outcome measure showed a consistent effect in favour of group clinics. Recent RCTs largely confirm previous findings. Health services outcomes – the evidence on costs and feasibility was equivocal. No rigorous evaluation of group clinics has been conducted in a UK setting. A good-quality qualitative study from the UK highlighted factors such as the physical space and a flexible appointment system as being important to patients. The views and attitudes of those who dislike group clinic provision are poorly represented. Little attention has been directed at the needs of people from ethnic minorities. The review team identified significant weaknesses in the included research. Potential selection bias limits the generalisability of the results. Many patients who could potentially be included do not consent to the group approach. Attendance is often interpreted liberally.LimitationsThis telescoped review, conducted within half the time period of a conventional systematic review, sought breadth in covering feasibility, appropriateness and meaningfulness in addition to effectiveness and cost-effectiveness and utilised several rapid-review methods. It focused on the contribution of recently published evidence from RCTs to the existing evidence base. It did not reanalyse trials covered in previous reviews. Following rapid review methods, we did not perform independent double data extraction and quality assessment.ConclusionsAlthough there is consistent and promising evidence for an effect of group clinics for some biomedical measures, this effect does not extend across all outcomes. Much of the evidence was derived from the USA. It is important to engage with UK stakeholders to identify NHS considerations relating to the implementation of group clinic approaches.Future workThe review team identified three research priorities: (1) more UK-centred evaluations using rigorous research designs and economic models with robust components; (2) clearer delineation of individual components within different models of group clinic delivery; and (3) clarification of the circumstances under which group clinics present an appropriate alternative to an individual consultation.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

The Fiscal Effects of Economic Immigration on Subnational Government Finance in Poland

e-Finanse ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 45-58
Author(s):  
Marzanna Poniatowicz ◽  
Agnieszka Piekutowska
Keyword(s):  
Social Policy ◽  
Income Tax ◽  
Research Question ◽  
Personal Income Tax ◽  
Government Finance ◽  
Subnational Government ◽  
Migration Research ◽  
The Impact ◽  
High Share

AbstractThe aim of the paper is to analyse the effects of economic immigration on subnational government finance (SNG) in Poland. The goal to achieve is to answer the following research question: what are the fiscal effects of immigration on SNG budget revenues and expenditures. To answer this question, logarithmic models were developed. The analysis refers to the years 2007-2016. In this respect, data from Statistics Poland - referring to budget revenues and expenditures of communes, cities of district status, districts and voivodeships - were used. As far as immigration statistics are concerned, data from the Ministry of Family, Labour and Social Policy were used. The results indicate an increase in both revenues and expenditures of SNG as a result of immigration. Such results can be explained inter alia by the nature of migration - research were focused on economic immigration. Results confirm that the level of employment of foreigners is one of the determinants shaping the fiscal effect of immigration. Moreover, the impact of economic immigration on SNG budget revenues and expenditures depends on the structure of this budget. This explains the differentiated results of the analysis of the impact of immigration on SNG in different countries. The positive correlation between immigration and SNG revenues in Poland can be associated with a high share of subnational governments in personal income tax revenues as this tax is one of the main categories of SNG revenues. Furthermore, results show that the impact of immigration on local government budgets in Poland is modest. This confirms the conclusions drawn by other authors (e.g. Auerbach and Oreopoulos), that in the long term, immigration cannot be considered as a potential instrument for resolving fiscal imbalances.

WikiRecs primary care: developing rapid recommendations for primary care through effective collaboration between systematic review and guideline teams

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697085
Author(s):  
Trudy Bekkering ◽  
Bert Aertgeerts ◽  
Ton Kuijpers ◽  
Mieke Vermandere ◽  
Jako Burgers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Clinical Practice ◽  
Primary Care Physicians ◽  
Urinary Stones ◽  
Care Practice ◽  
Supporting Evidence ◽  
Supervised Exercise ◽  
Review Team ◽  
New Evidence

BackgroundThe WikiRecs evidence summaries and recommendations for clinical practice are developed using trustworthy methods. The process is triggered by studies that may potentially change practice, aiming at implementing new evidence into practice fast.AimTo share our first experiences developing WikiRecs for primary care and to reflect on the possibilities and pitfalls of this method.MethodIn March 2017, we started developing WikiRecs for primary health care to speed up the process of making potentially practice-changing evidence in clinical practice. Based on a well-structured question a systematic review team summarises the evidence using the GRADE approach. Subsequently, an international panel of primary care physicians, methodological experts and patients formulates recommendations for clinical practice. The patient representatives are involved as full guideline panel members. The final recommendations and supporting evidence are disseminated using various platforms, including MAGICapp and scientific journals.ResultsWe are developing WikiRecs on two topics: alpha-blockers for urinary stones and supervised exercise therapy for intermittent claudication. We did not face major problems but will reflect on issues we had to solve so far. We anticipate having the first WikiRecs for primary care available at the end of 2017.ConclusionThe WikiRecs process is a promising method — that is still evolving — to rapidly synthesise and bring new evidence into primary care practice, while adhering to high quality standards.

scholarly journals How Effective Is Auditory–Verbal Therapy (AVT) for Building Language Development of Children with Cochlear Implants? A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 239
Author(s):  
Paris Binos ◽  
Elina Nirgianaki ◽  
George Psillas
Keyword(s):  
Systematic Review ◽  
Young Children ◽  
Cochlear Implants ◽  
Research Question ◽  
Voice Quality ◽  
Receptive Vocabulary ◽  
Pubmed Database ◽  
Mainstream Society ◽  
Meta Analyses ◽  
Auditory Verbal Therapy

This systematic review sheds light on the effectiveness of auditory–verbal therapy (AVT) outcomes in children with cochlear implants (CIs). The presented outcome is based on research findings from the last 10 years. The systematic review was designed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Critical Appraisal of Treatment Evidence (CATE) checklist. Specific keywords were chosen based on the research question and searched on the PubMed database. All searched papers were analysed based on specific exclusion criteria and classified into four evidence levels. The results revealed that children who participated in AV therapy can achieve linguistic skills at the same level as their hearing peers. Voice quality seemed positively affected, placing young children with CIs in the normal range for receptive vocabulary development. In contrast, reading skills seemed less benefited. AV therapy seems to contribute to integration into mainstream society. Despite the recorded speech and language improvements of young children with CIs, the aim of AV therapy is still not fulfilled. AV therapy can be seen as the best clinical practice for young children with CIs till now, but the lack of well-controlled studies is undermining.

scholarly journals Assessing Parent Behaviours in Parent–Child Interactions with Deaf and Hard of Hearing Infants Aged 0–3 Years: A Systematic Review

2021 ◽  
Vol 10 (15) ◽  
pp. 3345
Author(s):  
Martina Curtin ◽  
Evelien Dirks ◽  
Madeline Cruice ◽  
Rosalind Herman ◽  
Lauren Newman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Child Language ◽  
Evidence Base ◽  
Deaf Children ◽  
Clinical Tool ◽  
Coding Systems ◽  
Child Interaction ◽  
Parent Child Interaction ◽  
Parent Child

Background: Despite early identification and advancements in cochlear implant and hearing aid technology, delays in language skills in deaf children continue to exist. Good-quality parent–child interaction (PCI) is a key predictor for the successful development of deaf children’s signed and/or spoken language. Though professionals have standard assessments to monitor child language, a clinical tool to observe the quality of parental interaction is yet to be developed. Aims and methods: This systematic review with narrative synthesis aims to uncover which parent behaviours are assessed in PCI studies with deaf infants aged 0–3 years, how these behaviours are assessed, and which are correlated with higher scores in child language. Results: Sixty-one papers were included, spanning 40 years of research. Research included in the review assessed parents’ skills in gaining attention, joint engagement, emotional sensitivity, and language input. PCI was mostly assessed using coding systems and frame-by-frame video analysis. Some of the parent behaviours mentioned previously are associated with more words produced by deaf children. Conclusion: The results of the review provide the evidence base required to develop the content of a future clinical assessment tool for parent–child interaction in deafness.

scholarly journals Study protocol of a systematic review and qualitative evidence synthesis using two different approaches: Healthcare related needs and desires of older people with post-stroke aphasia

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e039348
Author(s):  
Nadine Janis Pohontsch ◽  
Thorsten Meyer ◽  
Yvonne Eisenmann ◽  
Maria-Inti Metzendorf ◽  
Verena Leve ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Research Question ◽  
Treatment Success ◽  
Qualitative Studies ◽  
Qualitative Evidence Synthesis ◽  
Healthcare Needs ◽  
Qualitative Evidence

IntroductionStroke is a frequent disease in the older population of Western Europe with aphasia as a common consequence. Aphasia is known to impede targeting treatment to individual patients’ needs and therefore may reduce treatment success. In Germany, the postacute care of patients who had stroke is provided by different healthcare institutions of different sectors (rehabilitation, nursing and primary care) with substantial difficulties to coordinate services. We will conduct two qualitative evidence syntheses (QESs) aiming at exploring distinct healthcare needs and desires of older people living with poststroke aphasia. We thereby hope to support the development of integrated care models based on needs of patients who are very restricted to communicate them. Since various methods of QESs exist, the aim of the study embedding the two QESs was to determine if findings differ according to the approach used.Methods and analysisWe will conduct two QESs by using metaethnography (ME) and thematic synthesis (ThS) independently to synthesise the findings of primary qualitative studies. The main differences between these two methods are the underlying epistemologies (idealism (ME) vs realism (ThS)) and the type of research question (emerging (ME) vs fixed (ThS)).We will search seven bibliographical databases. Inclusion criteria comprise: patients with poststroke aphasia, aged 65 years and older, studies in German/English, all types of qualitative studies concerning needs and desires related to healthcare or the healthcare system. The protocol was registered in the International Prospective Register of Systematic Reviews, follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and includes three items from the Enhancing Transparency in Reporting the synthesis of Qualitative Research checklist.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented on national conferences.

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