Maureen Dobbins Jeremy Grimshaw Michael Wilson

Transcription

1 Maureen Dobbins Jeremy Grimshaw Michael Wilson

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3 Use of systematic reviews by different stakeholder groups hindered by: significant growth in number of systematic reviews dispersion of reviews across large number of sources variability in quality of systematic reviews interpretability of systematic reviews time

4 Health Evidence, Health Systems Evidence, Rx for Change are three responses to these challenges to better support use of systematic reviews by different stakeholder groups Added value portals facilitating ease of access and interpretation of systematic reviews (and other syntheses/knowledge tools)

5 To introduce audience to these resources To discuss the potential value of these resources for stakeholder groups To discuss challenges and issues faced by the developers of these resources

6 Rx for Change An online database of key findings from systematic reviews to improve drug prescribing practice and health care delivery Jeremy Grimshaw Cochrane Effective Practice and Organisation of Care (EPOC) Group

7 Canadian Agency for Drugs and Technologies in Health Cochrane Consumers and Communication Review Group

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9 Over 300 systematic reviews Quality assessed using AMSTAR scale Includes: overall summary of interventions summaries of individual reviews quality assessments links to included and excluded studies Searchable

10 Intervention category Intervention definition

11 Professional interventions influencing all behaviours Financial interventions, organisational interventions, or regulatory interventions influencing prescribing Consumer-targeted interventions influencing drug use

12 Provides decision makers with reliable, up-todate, evidence-based information These resources assist in: the improvement of drug prescription and use the selection of strategies that promote the optimal use of medicines from a professional and consumer perspective

13 April 2007 Most recent update April 2010 (includes reviews up to September 2009) Three planned updates over the next 2 years

14 Title and abstract screening criteria (focuses on interventions, outcomes and target population) Full text screening criteria (focuses on methods and confirms appropriateness of interventions) Quality assessment using the AMSTAR checklist Standardized tables for results

15 Developed and conducted by an information specialist Detailed electronic searches of 4 main electronic databases (MEDLINE, The Cochrane Library, Database of Abstracts of Reviews of Effects (DARE), and EMBASE) using combinations of keywords and subject headings Systematic title-abstract and full-text screening by 2 independent reviewers, any conflicts resolved

16 AMSTAR an 11-item checklist where reviews score one point for each criterion met Assessed by 2 independent reviewers, disagreements resolved by consensus Where disagreement or uncertainty prevails, a senior member of the team is consulted for the final decision Reviews rated to be of moderate (>4) or high (>7) methodological quality (AMSTAR scores of 4 or more) qualify for data abstraction and analysis and are included in the database

17 Reviews were appraised and results summarized by: Vote counting (generally effective, mixed, generally ineffective) Effect sizes, if reported (small, modest, large) Re-analysis was conducted when required

18 Includes results and conclusions section for each review, based on the data presented in the Table of Results Conclusions reported for overall intervention effectiveness, and effectiveness of prescribingrelated outcomes

19 Option 1: Search via categories

20 Option 2: Search via text search

21 Succinct, practical summaries of recent findings about the effects of interventions to improve the quality of prescribing and healthcare delivery

22 Definition Summary of intervention effectiveness Summary of overall findings from reviews Summary of findings related to prescribing List of the reviews that addressed the intervention and met the quality assessment, and their AMSTAR score

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24 Include: Background summary List of included studies within review with PubMed links, where available Time period evidence was searched Number of included studies all outcomes and prescribing Study design, characteristics and quality score Summary of results and conclusions Table of results

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26 Rxforchange online tutorial Methods for Development Rxforchange Interventions for Change fact sheet List of Excluded Studies due to low quality scores

27 Jeremy Grimshaw, Co-ordinating Editor, EPOC; Janet Crain, Senior Communications Advisor, CADTH Alain Mayhew, Managing Editor, EPOC;

28 Key benefits of these resources Tailored to needs of specific stakeholder audience Credibility of developers to specific stakeholder audience Added value components (AMSTAR rating, naturalistic categorisation, additional tools and resources)

29 Ongoing issues that we face include: Sustainability Updating Funding Evolving technology Other dissemination and implementation activities

30 THANK YOU!