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Engler K, Avallone F, Cadri A, Lebouché B. Patient-reported outcome measures in adult HIV care: A rapid scoping review of targeted outcomes and instruments used. HIV Med 2024; 25:633-674. [PMID: 38282323 DOI: 10.1111/hiv.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/20/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE There is international interest in the integration of patient-reported outcome measures (PROMs) into routine HIV care, but little work has synthesized the content of published initiatives. We conducted a rapid scoping review primarily to identify their selected patient-reported outcomes and respective instruments. METHODS Four databases were searched on 4 May 2022 (Medline, Embase, CINAHL and PsychINFO) for relevant English language documents published from 2005 onwards. Dual review of at least 20% of records, full texts and data extraction was performed. Outcomes and instruments were classified with an adapted 14-domain taxonomy. Instruments with evidence of validation were described. RESULTS Of 13 062 records generated for review, we retained a final sample of 94 documents, referring to 60 distinct initiatives led mostly in the USA (n = 29; 48% of initiatives), Europe (n = 16; 27%) and Africa (n = 9; 15%). The measured patient-reported outcome domains were: mental health (n = 42; 70%), substance use (n = 23; 38%), self-management (n = 16; 27%), symptoms (n = 12; 20%), sexual/reproductive health (n = 12; 20%), physical health (n = 9; 15%), treatment (n= 8; 13%), cognition (n = 7; 12%), quality of life (n = 7; 12%), violence/abuse (n = 6; 10%), stigma (n = 6; 10%), socioeconomic issues (n = 5; 8%), social support (n = 3; 5%) and body/facial appearance (n = 1; 2%). Initiatives measured 2.6 outcome domains, on average (range = 1-11). In total, 62 distinct validated PROMs were identified, with 53 initiatives (88%) employing at least one (M = 2.2). Overwhelmingly, the most used instrument was any version of the Patient Health Questionnaire to measure symptoms of depression, employed by over a third (26; 43%) of initiatives. CONCLUSION Published PROM initiatives in HIV care have spanned 19 countries and disproportionately target mental health and substance use.
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Affiliation(s)
- Kim Engler
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Francesco Avallone
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Abdul Cadri
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- Chronic Viral Illness Service, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Bagg MK, Hicks AJ, Hellewell SC, Ponsford JL, Lannin NA, O'Brien TJ, Cameron PA, Cooper DJ, Rushworth N, Gabbe BJ, Fitzgerald M. The Australian Traumatic Brain Injury Initiative: Statement of Working Principles and Rapid Review of Methods to Define Data Dictionaries for Neurological Conditions. Neurotrauma Rep 2024; 5:424-447. [PMID: 38660461 PMCID: PMC11040195 DOI: 10.1089/neur.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to develop a health informatics approach to collect data predictive of outcomes for persons with moderate-severe TBI across Australia. Central to this approach is a data dictionary; however, no systematic reviews of methods to define and develop data dictionaries exist to-date. This rapid systematic review aimed to identify and characterize methods for designing data dictionaries to collect outcomes or variables in persons with neurological conditions. Database searches were conducted from inception through October 2021. Records were screened in two stages against set criteria to identify methods to define data dictionaries for neurological conditions (International Classification of Diseases, 11th Revision: 08, 22, and 23). Standardized data were extracted. Processes were checked at each stage by independent review of a random 25% of records. Consensus was reached through discussion where necessary. Thirty-nine initiatives were identified across 29 neurological conditions. No single established or recommended method for defining a data dictionary was identified. Nine initiatives conducted systematic reviews to collate information before implementing a consensus process. Thirty-seven initiatives consulted with end-users. Methods of consultation were "roundtable" discussion (n = 30); with facilitation (n = 16); that was iterative (n = 27); and frequently conducted in-person (n = 27). Researcher stakeholders were involved in all initiatives and clinicians in 25. Importantly, only six initiatives involved persons with lived experience of TBI and four involved carers. Methods for defining data dictionaries were variable and reporting is sparse. Our findings are instructive for AUS-TBI and can be used to further development of methods for defining data dictionaries.
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Affiliation(s)
- Matthew K. Bagg
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Amelia J. Hicks
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Sarah C. Hellewell
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Jennie L. Ponsford
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Natasha A. Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Terence J. O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peter A. Cameron
- National Trauma Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D. Jamie Cooper
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Nick Rushworth
- Brain Injury Australia, Sydney, New South Wales, Australia
| | - Belinda J. Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, United Kingdom
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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3
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Guo Q, Jiang G, Zhao Q, Long Y, Feng K, Gu X, Xu Y, Li Z, Huang J, Du L. Rapid review: A review of methods and recommendations based on current evidence. J Evid Based Med 2024. [PMID: 38512942 DOI: 10.1111/jebm.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
Rapid review (RR) could accelerate the traditional systematic review (SR) process by simplifying or omitting steps using various shortcuts. With the increasing popularity of RR, numerous shortcuts had emerged, but there was no consensus on how to choose the most appropriate ones. This study conducted a literature search in PubMed from inception to December 21, 2023, using terms such as "rapid review" "rapid assessment" "rapid systematic review" and "rapid evaluation". We also scanned the reference lists and performed citation tracking of included impact studies to obtain more included studies. We conducted a narrative synthesis of all RR approaches, shortcuts and studies assessing their effectiveness at each stage of RRs. Based on the current evidence, we provided recommendations on utilizing certain shortcuts in RRs. Ultimately, we identified 185 studies focusing on summarizing RR approaches and shortcuts, or evaluating their impact. There was relatively sufficient evidence to support the use of the following shortcuts in RRs: limiting studies to those published in English-language; conducting abbreviated database searches (e.g., only searching PubMed/MEDLINE, Embase, and CENTRAL); omitting retrieval of grey literature; restricting the search timeframe to the recent 20 years for medical intervention and the recent 15 years for reviewing diagnostic test accuracy; conducting a single screening by an experienced screener. To some extent, the above shortcuts were also applicable to SRs. This study provided a reference for future RR researchers in selecting shortcuts, and it also presented a potential research topic for methodologists.
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Affiliation(s)
- Qiong Guo
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Guiyu Jiang
- West China School of Public Health, Sichuan University, Chengdu, P. R. China
| | - Qingwen Zhao
- West China School of Public Health, Sichuan University, Chengdu, P. R. China
| | - Youlin Long
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Kun Feng
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Xianlin Gu
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Yihan Xu
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Center for education of medical humanities, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Zhengchi Li
- Center for education of medical humanities, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Jin Huang
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Liang Du
- Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, P. R. China
- West China Medical Publishers, West China Hospital, Sichuan University, Chengdu, P. R. China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
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Haby MM, Barreto JOM, Kim JYH, Peiris S, Mansilla C, Torres M, Guerrero-Magaña DE, Reveiz L. What are the best methods for rapid reviews of the research evidence? A systematic review of reviews and primary studies. Res Synth Methods 2024; 15:2-20. [PMID: 37696668 DOI: 10.1002/jrsm.1664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/09/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
Rapid review methodology aims to facilitate faster conduct of systematic reviews to meet the needs of the decision-maker, while also maintaining quality and credibility. This systematic review aimed to determine the impact of different methodological shortcuts for undertaking rapid reviews on the risk of bias (RoB) of the results of the review. Review stages for which reviews and primary studies were sought included the preparation of a protocol, question formulation, inclusion criteria, searching, selection, data extraction, RoB assessment, synthesis, and reporting. We searched 11 electronic databases in April 2022, and conducted some supplementary searching. Reviewers worked in pairs to screen, select, extract data, and assess the RoB of included reviews and studies. We included 15 systematic reviews, 7 scoping reviews, and 65 primary studies. We found that several commonly used shortcuts in rapid reviews are likely to increase the RoB in the results. These include restrictions based on publication date, use of a single electronic database as a source of studies, and use of a single reviewer for screening titles and abstracts, selecting studies based on the full-text, and for extracting data. Authors of rapid reviews should be transparent in reporting their use of these shortcuts and acknowledge the possibility of them causing bias in the results. This review also highlights shortcuts that can save time without increasing the risk of bias. Further research is needed for both systematic and rapid reviews on faster methods for accurate data extraction and RoB assessment, and on development of more precise search strategies.
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Affiliation(s)
- Michelle M Haby
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Mexico
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Jenny Yeon Hee Kim
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Sasha Peiris
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Cristián Mansilla
- McMaster Health Forum, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Marcela Torres
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
| | - Diego Emmanuel Guerrero-Magaña
- Doctoral Program in Chemical and Biological Sciences and Health, Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Mexico
| | - Ludovic Reveiz
- Science and Knowledge Unit, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC, USA
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Griebler U, Dobrescu A, Ledinger D, Klingenstein P, Sommer I, Emprechtinger R, Persad E, Gadinger A, Trivella M, Klerings I, Nussbaumer-Streit B. Evaluation of the interim Cochrane rapid review methods guidance-A mixed-methods study on the understanding of and adherence to the guidance. Res Synth Methods 2023; 14:824-846. [PMID: 37483013 DOI: 10.1002/jrsm.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/11/2023] [Accepted: 07/02/2023] [Indexed: 07/25/2023]
Abstract
The Cochrane Rapid Review Methods Group (RRMG) first released interim guidance in March 2020 to support authors in conducting rapid reviews (RRs). The objective of this mixed-methods study was to assess the adherence and investigate authors' understanding of the RRMG guidance. We identified all documents citing the Interim Cochrane RRMG guidance up to February 17, 2022 and performed an exploratory adherence analysis. We interviewed 20 RR authors to assess the recommendations' comprehensibility and reasons for any deviations. Further, we surveyed nine authors of COVID-19-related Cochrane reviews for their reasons for not conducting a RR. We analyzed 128 RRs (111 non-Cochrane, 17 Cochrane) that cited the RRMG guidance. Several recommendations were not followed by a large proportion of RR authors such as stepwise approach to study design inclusion or peer review of search strategies, whereas others were exceeded, for example, dual independent screening of abstracts/full texts. The most reported reasons for deviating from the guidance were time constraints, unclarities in the recommended approach, or inapplicability to the specific RR. Overall, the guidance was viewed as user-friendly; however, without pre-existing knowledge of systematic review (SR) conduct, the application was perceived as difficult. The main reasons for conducting a full SR over a RR were late availability of the guidance, preset mandate to conduct a SR, uncertainty regarding methodological distinctions between SR and RR, and inapplicability to the evidence base. Clarifications are warranted throughout the Interim Cochrane RRMG guidance to ensure that users with various experience levels can understand and apply its recommendations accordingly.
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Affiliation(s)
- Ursula Griebler
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Andreea Dobrescu
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Dominic Ledinger
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Pauline Klingenstein
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Isolde Sommer
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Robert Emprechtinger
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
- Faculty of Health and Medicine, University of Krems, Krems an der Donau, Austria
| | - Emma Persad
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Arianna Gadinger
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Marialena Trivella
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
- Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Irma Klerings
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Barbara Nussbaumer-Streit
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
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Holmes Fee C, Hicklen RS, Jean S, Abu Hussein N, Moukheiber L, de Lota MF, Moukheiber M, Moukheiber D, Anthony Celi L, Dankwa-Mullan I. Strategies and solutions to address Digital Determinants of Health (DDOH) across underinvested communities. PLOS DIGITAL HEALTH 2023; 2:e0000314. [PMID: 37824481 PMCID: PMC10569606 DOI: 10.1371/journal.pdig.0000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Healthcare has long struggled to improve services through technology without further widening health disparities. With the significant expansion of digital health, a group of healthcare professionals and scholars from across the globe are proposing the official usage of the term "Digital Determinants of Health" (DDOH) to explicitly call out the relationship between technology, healthcare, and equity. This is the final paper in a series published in PLOS Digital Health that seeks to understand and summarize current knowledge of the strategies and solutions that help to mitigate the negative effects of DDOH for underinvested communities. Through a search of English-language Medline, Scopus, and Google Scholar articles published since 2010, 345 articles were identified that discussed the application of digital health technology among underinvested communities. A group of 8 reviewers assessed 132 articles selected at random for the mention of solutions that minimize differences in DDOH. Solutions were then organized by categories of policy; design and development; implementation and adoption; and evaluation and ongoing monitoring. The data were then assessed by category and the findings summarized. The reviewers also looked for common themes across the solutions and evidence of effectiveness. From this limited scoping review, the authors found numerous solutions mentioned across the papers for addressing DDOH and many common themes emerged regardless of the specific community or digital health technology under review. There was notably less information on solutions regarding ongoing evaluation and monitoring which corresponded with a lack of research evidence regarding effectiveness. The findings directionally suggest that universal strategies and solutions can be developed to address DDOH independent of the specific community under focus. With the need for the further development of DDOH measures, we also provide a framework for DDOH assessment.
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Affiliation(s)
- Casey Holmes Fee
- Healthcare Consultant, Newton, Massachusetts, United States of America
| | - Rachel Scarlett Hicklen
- Research Medical Library, MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Sidney Jean
- Massachusetts Executive Office of Health and Human Services, Boston, Massachusetts, United States of America
- Simmons University, Boston, Massachusetts, United States of America
| | - Nebal Abu Hussein
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department for BioMedical Research DBMR, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lama Moukheiber
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | | | - Mira Moukheiber
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Dana Moukheiber
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Leo Anthony Celi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Division of Pulmonary, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Irene Dankwa-Mullan
- Marti Health, Atlanta, Georgia, United States of America
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
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Vieira AM, Szczepanik G, de Waure C, Tricco AC, Oliver S, Stojanovic J, Ribeiro PAB, Pollock D, Akl EA, Lavis J, Kuchenmuller T, Bragge P, Langer L, Bacon S. Identifying priority questions regarding rapid systematic reviews' methods: protocol for an eDelphi study. BMJ Open 2023; 13:e069856. [PMID: 37419644 PMCID: PMC10335584 DOI: 10.1136/bmjopen-2022-069856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
INTRODUCTION Rapid systematic reviews (RRs) have the potential to provide timely information to decision-makers, thus directly impacting healthcare. However, consensus regarding the most efficient approaches to performing RRs and the presence of several unaddressed methodological issues pose challenges. With such a large potential research agenda for RRs, it is unclear what should be prioritised. OBJECTIVE To elicit a consensus from RR experts and interested parties on what are the most important methodological questions (from the generation of the question to the writing of the report) for the field to address in order to guide the effective and efficient development of RRs. METHODS AND ANALYSIS An eDelphi study will be conducted. Researchers with experience in evidence synthesis and other interested parties (eg, knowledge users, patients, community members, policymaker, industry, journal editors and healthcare providers) will be invited to participate. The following steps will be taken: (1) a core group of experts in evidence synthesis will generate the first list of items based on the available literature; (2) using LimeSurvey, participants will be invited to rate and rank the importance of suggested RR methodological questions. Questions with open format responses will allow for modifications to the wording of items or the addition of new items; (3) three survey rounds will be performed asking participants to re-rate items, with items deemed of low importance being removed at each round; (4) a list of items will be generated with items believed to be of high importance by ≥75% of participants being included and (5) this list will be discussed at an online consensus meeting that will generate a summary document containing the final priority list. Data analysis will be performed using raw numbers, means and frequencies. ETHICS AND DISSEMINATION This study was approved by the Concordia University Human Research Ethics Committee (#30015229). Both traditional, for example, scientific conference presentations and publication in scientific journals, and non-traditional, for example, lay summaries and infographics, knowledge translation products will be created.
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Affiliation(s)
- Ariany M Vieira
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, Québec, Canada
| | - Geneviève Szczepanik
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, Québec, Canada
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute of St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sandy Oliver
- University College London Institute of Education, London, UK
| | - Jovana Stojanovic
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, Québec, Canada
| | - Paula A B Ribeiro
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, Québec, Canada
| | - Danielle Pollock
- Health Evidence Synthesis, Recommendations and Impact, School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - John Lavis
- McMaster Health Forum and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Affiliate Scientist, Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Tanja Kuchenmuller
- Research for Health Department,Science Division, World Health Organization, Geneva, Switzerland
| | - Peter Bragge
- Monash Sustainable Development Institute Evidence Review Service, BehaviourWorks Australia, Monash University, Melbourne, Victoria, Australia
| | - Laurenz Langer
- South Africa Centre for Evidence, Johannesburg, South Africa
| | - Simon Bacon
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Québec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, Québec, Canada
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8
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Walsh G, Stogiannos N, van de Venter R, Rainey C, Tam W, McFadden S, McNulty JP, Mekis N, Lewis S, O'Regan T, Kumar A, Huisman M, Bisdas S, Kotter E, Pinto dos Santos D, Sá dos Reis C, van Ooijen P, Brady AP, Malamateniou C. Responsible AI practice and AI education are central to AI implementation: a rapid review for all medical imaging professionals in Europe. BJR Open 2023; 5:20230033. [PMID: 37953871 PMCID: PMC10636340 DOI: 10.1259/bjro.20230033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 11/14/2023] Open
Abstract
Artificial intelligence (AI) has transitioned from the lab to the bedside, and it is increasingly being used in healthcare. Radiology and Radiography are on the frontline of AI implementation, because of the use of big data for medical imaging and diagnosis for different patient groups. Safe and effective AI implementation requires that responsible and ethical practices are upheld by all key stakeholders, that there is harmonious collaboration between different professional groups, and customised educational provisions for all involved. This paper outlines key principles of ethical and responsible AI, highlights recent educational initiatives for clinical practitioners and discusses the synergies between all medical imaging professionals as they prepare for the digital future in Europe. Responsible and ethical AI is vital to enhance a culture of safety and trust for healthcare professionals and patients alike. Educational and training provisions for medical imaging professionals on AI is central to the understanding of basic AI principles and applications and there are many offerings currently in Europe. Education can facilitate the transparency of AI tools, but more formalised, university-led training is needed to ensure the academic scrutiny, appropriate pedagogy, multidisciplinarity and customisation to the learners' unique needs are being adhered to. As radiographers and radiologists work together and with other professionals to understand and harness the benefits of AI in medical imaging, it becomes clear that they are faced with the same challenges and that they have the same needs. The digital future belongs to multidisciplinary teams that work seamlessly together, learn together, manage risk collectively and collaborate for the benefit of the patients they serve.
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Affiliation(s)
- Gemma Walsh
- Division of Midwifery & Radiography, City University of London, London, United Kingdom
| | | | | | - Clare Rainey
- School of Health Sciences, Ulster University, Derry~Londonderry, Northern Ireland
| | - Winnie Tam
- Division of Midwifery & Radiography, City University of London, London, United Kingdom
| | - Sonyia McFadden
- School of Health Sciences, Ulster University, Coleraine, United Kingdom
| | | | - Nejc Mekis
- Medical Imaging and Radiotherapy Department, University of Ljubljana, Faculty of Health Sciences, Ljubljana, Slovenia
| | - Sarah Lewis
- Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Tracy O'Regan
- The Society and College of Radiographers, London, United Kingdom
| | - Amrita Kumar
- Frimley Health NHS Foundation Trust, Frimley, United Kingdom
| | - Merel Huisman
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | | | | | - Cláudia Sá dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
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Cooke SJ, Cook CN, Nguyen VM, Walsh JC, Young N, Cvitanovic C, Grainger MJ, Randall NP, Muir M, Kadykalo AN, Monk KA, Pullin AS. Environmental evidence in action: on the science and practice of evidence synthesis and evidence-based decision-making. ENVIRONMENTAL EVIDENCE 2023; 12:10. [PMID: 37220478 PMCID: PMC10191815 DOI: 10.1186/s13750-023-00302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/27/2023] [Indexed: 05/25/2023]
Abstract
In civil society we expect that policy and management decisions will be made using the best available evidence. Yet, it is widely known that there are many barriers that limit the extent to which that occurs. One way to overcome these barriers is via robust, comprehensive, transparent and repeatable evidence syntheses (such as systematic reviews) that attempt to minimize various forms of bias to present a summary of existing knowledge for decision-making purposes. Relative to other disciplines (e.g., health care, education), such evidence-based decision-making remains relatively nascent for environment management despite major threats to humanity, such as the climate, pollution and biodiversity crises demonstrating that human well-being is inextricably linked to the biophysical environment. Fortunately, there are a growing number of environmental evidence syntheses being produced that can be used by decision makers. It is therefore an opportune time to reflect on the science and practice of evidence-based decision-making in environment management to understand the extent to which evidence syntheses are embraced and applied in practice. Here we outline a number of key questions related to the use of environmental evidence that need to be explored in an effort to enhance evidence-based decision-making. There is an urgent need for research involving methods from social science, behavioural sciences, and public policy to understand the basis for patterns and trends in environmental evidence use (or misuse or ignorance). There is also a need for those who commission and produce evidence syntheses, as well as the end users of these syntheses to reflect on their experiences and share them with the broader evidence-based practice community to identify needs and opportunities for advancing the entire process of evidence-based practice. It is our hope that the ideas shared here will serve as a roadmap for additional scholarship that will collectively enhance evidence-based decision-making and ultimately benefit the environment and humanity.
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Affiliation(s)
- Steven J. Cooke
- Canadian Centre for Evidence-Based Conservation, Department of Biology and Institute of Environmental and Interdisciplinary Science, Carleton University, 1125 Colonel By Dr., Ottawa, ON K1S 5B6 Canada
| | - Carly N. Cook
- School of Biological Sciences, Monash University, 25 Rainforest Walk, Clayton, VIC 3800 Australia
| | - Vivian M. Nguyen
- Canadian Centre for Evidence-Based Conservation, Department of Biology and Institute of Environmental and Interdisciplinary Science, Carleton University, 1125 Colonel By Dr., Ottawa, ON K1S 5B6 Canada
| | - Jessica C. Walsh
- School of Biological Sciences, Monash University, 25 Rainforest Walk, Clayton, VIC 3800 Australia
| | - Nathan Young
- School of Sociological and Anthropological Studies, University of Ottawa, 20 University Private, Ottawa, ON K1N 6N5 Canada
| | | | - Matthew J. Grainger
- Norwegian Institute for Nature Research-NINA, Torgarden, 5685, 7485 Trondheim, Norway
| | - Nicola P. Randall
- Centre for Evidence Based Agriculture, Harper Adams University, Newport, Shropshire, TF10 8NB UK
| | - Matt Muir
- U.S. Fish & Wildlife Service, 5275 Leesburg Pike, Falls Church, VA 22041-3803 USA
| | - Andrew N. Kadykalo
- Department of Natural Resource Sciences, McGill University, 111 Lakeshore Blvd, Ste-Anne-de-Bellevue, QC H9X 3V9 Canada
| | - Kathryn A. Monk
- Department of Biosciences, Swansea University, Swansea, SA2 8PP UK
| | - Andrew S. Pullin
- School of Natural Sciences, Bangor University, Bangor, LL57 2DG UK
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Bragge P, Waddell A, Kellner P, Delafosse V, Marten R, Nordström A, Demaio S. Characteristics of successful government-led interventions to support healthier populations: a starting portfolio of positive outlier examples. BMJ Glob Health 2023; 8:e011683. [PMID: 37225262 PMCID: PMC10230917 DOI: 10.1136/bmjgh-2023-011683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/03/2023] [Indexed: 05/26/2023] Open
Abstract
Despite progress on the Millennium and Sustainable Development Goals, significant public health challenges remain to address communicable and non-communicable diseases and health inequities. The Healthier Societies for Healthy Populations initiative convened by WHO's Alliance for Health Policy and Systems Research; the Government of Sweden; and the Wellcome Trust aims to address these complex challenges. One starting point is to build understanding of the characteristics of successful government-led interventions to support healthier populations. To this end, this project explored five purposefully sampled, successful public health initiatives: front-of-package warnings on food labels containing high sugar, sodium or saturated fat (Chile); healthy food initiatives (trans fats, calorie labelling, cap on beverage size; New York); the alcohol sales and transport ban during COVID-19 (South Africa); the Vision Zero road safety initiative (Sweden) and establishment of the Thai Health Promotion Foundation. For each initiative a qualitative, semistructured one-on-one interview with a key leader was conducted, supplemented by a rapid literature scan with input from an information specialist. Thematic analysis of the five interviews and 169 relevant studies across the five examples identified facilitators of success including political leadership, public education, multifaceted approaches, stable funding and planning for opposition. Barriers included industry opposition, the complex nature of public health challenges and poor interagency and multisector co-ordination. Further examples building on this global portfolio will deepen understanding of success factors or failures over time in this critical area.
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Affiliation(s)
- Peter Bragge
- Monash Sustainable Development Institute Evidence Review Service, Monash University, Clayton, Victoria, Australia
| | - Alex Waddell
- Monash Sustainable Development Institute Evidence Review Service, Monash University, Clayton, Victoria, Australia
| | - Paul Kellner
- Monash Sustainable Development Institute Evidence Review Service, Monash University, Clayton, Victoria, Australia
| | | | | | | | - Sandro Demaio
- Victorian Health Promotion Foundation, Carlton South, Victoria, Australia
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Husereau D, Sullivan T, Feilotter HE, Gomes MM, Juergens R, Sheffield BS, Kassam S, Stockley TL, Jacobs P. Optimizing the delivery of genetic and advanced diagnostic testing in the province of Ontario: challenges and implications for laboratory technology assessment and management in decentralized healthcare systems. J Med Econ 2022; 25:993-1004. [PMID: 35850613 DOI: 10.1080/13696998.2022.2101807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIMS The Canadian province of Ontario provides full coverage for its residents (pop.14.8 M) for hospital-based diagnostic testing. Historical governance of the healthcare system and a legacy scheme of health technology assessment (HTA) and financing has led to a suboptimal approach of adopting advanced diagnostic technology (i.e. protein expression, cytogenetic, and molecular/genetic) for guiding therapeutic decisions. The aim of this research is to explore systemic barriers and provide guidance to improve patient and care provider experiences by reducing delays and inequity of access to testing, while benefitting laboratory innovators and maximizing system efficiency. MATERIALS AND METHODS A mixed-methods approach including literature review, semi-structured interviews, and a multi-stakeholder forum involving patient representatives (n = 1), laboratory leaders (n = 6), physicians (n = 5), Ministry personnel (n = 4), administrators (n = 3), extra-provincial experts, and researchers (n = 7), as well as pharmaceutical (n = 5) and diagnostic companies (n = 2). The forum considered evidence of good practices in adoption, implementation, and financing laboratory services and identified barriers as well as feasible options for improving advanced diagnostic testing in Ontario. RESULTS Overarching challenges identified included: barriers to define what is needed; need for a clear approach to adoption; and the need for more oversight and coordination. Recommendations to address these included a shift to an anticipatory system of test adoption, creating a fit-for-purpose system of health technology management that consolidates existing evaluation processes, and modernizing the governance and financing of testing so that it is managed at a care-delivery level. CONCLUSIONS The proposals for change in Ontario highlight the role that HTA, governance, and financing of health technology play along the continuum of a health technology life cycle within a healthcare system where decision-making is highly decentralized. Resource availability and capacity were not a concern - instead, solutions require higher levels of coordination and system integration along with innovative approaches to HTA.
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Affiliation(s)
- Don Husereau
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Terrence Sullivan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada
| | | | - Marcio M Gomes
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ontario, Canada
- Anatomical Pathologist, The Ottawa Hospital, Ottawa, Canada
| | - Rosalyn Juergens
- Division of Medical Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Canada
| | | | - Shaqil Kassam
- Stronach Regional Cancer Centre, Southlake Regional Health Centre, Newmarket, Canada
| | - Tracy L Stockley
- Division of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Philip Jacobs
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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