Periodic Reporting for period 1 - Living Evidence (Living Evidence to inform health decisions: Development of capacity for the production and use of reliable, friendly and updated health evidence synthesis.)
Okres sprawozdawczy: 2020-09-07 do 2022-09-06
Every day in the world, important healthcare decisions are made with incomplete or outdated information about the effects (benefits and harms) of the different healthcare interventions available. Evaluating the best available evidence as a whole on a given health problem to make well-informed clinical and health policy decisions is increasingly challenging. Despite constant advances in the appropriation of scientific knowledge and technological developments, there is still a gap among healthcare professionals in producing and using the most current evidence for decision-making. There is a need to strengthen the capacity of the different actors of the health system to better leverage the methodological developments and existing technologies in a fast and efficient manner on which to base their decision-making process.
“Living Evidence to inform health decisions” is a knowledge transfer and capacity-building research project involving the design and evaluation of a model strategy that will allow health system organizations to generate, use, and apply innovative tools to support health decisions to be based on the most recent evidence.
It seeks to apply the methodological approach known as “Living evidence” (LE) which has mainly been developed for systematic reviews (SR), to any other type of evidence synthesis. Particularly those syntheses that are carried out as part of the documents aimed to inform health decision-makers, known as “knowledge transfer (KT) products”.
In practice, LE means continual surveillance for new research evidence through ongoing or frequent searches and the inclusion of relevant new information into the existing synthesis in a timely manner so that the findings of the synthesis remain up to date. This approach, when applied to the resolution of relevant and rapidly changing clinical questions, is optimal to ensure a rapid update of the evidence that informs on the effects of controversial health interventions and/or clinical recommendations, where there are uncertainties.
The living Evidence to inform health decisions project addressed critical features of the LE model that are consistent with recent efforts, to develop a strategy for building capacity among health sector organizations for the production, maintenance, and use of living evidence synthesis. As part of this strategy development process, we defined the living evidence to inform health decisions framework (LE-IHD framework) that seeks to provide empirical support for a range of actions used to incorporate living evidence synthesis in different KT projects. Our aim is that the capacity-building strategy and the LE-IHD framework can be applied to any country or region, increasing the impact of health research, and reducing the costs and time consumption related to KT-products development and updating processes. So all types of healthcare decisions could be based on the most current evidence thanks to it being constantly updated when new studies become available.
As a capacity-building research project, our main objective was to develop and test a strategy that permits obtaining, improving, and retaining new skills and knowledge needed to develop and use “Living evidence synthesis” among members of health system organizations in charge of developing KT products to inform health decisions.
“Living Evidence to inform health decisions” is a knowledge transfer and capacity-building research project involving the design and evaluation of a model strategy that will allow health system organizations to generate, use, and apply innovative tools to support health decisions to be based on the most recent evidence.
It seeks to apply the methodological approach known as “Living evidence” (LE) which has mainly been developed for systematic reviews (SR), to any other type of evidence synthesis. Particularly those syntheses that are carried out as part of the documents aimed to inform health decision-makers, known as “knowledge transfer (KT) products”.
In practice, LE means continual surveillance for new research evidence through ongoing or frequent searches and the inclusion of relevant new information into the existing synthesis in a timely manner so that the findings of the synthesis remain up to date. This approach, when applied to the resolution of relevant and rapidly changing clinical questions, is optimal to ensure a rapid update of the evidence that informs on the effects of controversial health interventions and/or clinical recommendations, where there are uncertainties.
The living Evidence to inform health decisions project addressed critical features of the LE model that are consistent with recent efforts, to develop a strategy for building capacity among health sector organizations for the production, maintenance, and use of living evidence synthesis. As part of this strategy development process, we defined the living evidence to inform health decisions framework (LE-IHD framework) that seeks to provide empirical support for a range of actions used to incorporate living evidence synthesis in different KT projects. Our aim is that the capacity-building strategy and the LE-IHD framework can be applied to any country or region, increasing the impact of health research, and reducing the costs and time consumption related to KT-products development and updating processes. So all types of healthcare decisions could be based on the most current evidence thanks to it being constantly updated when new studies become available.
As a capacity-building research project, our main objective was to develop and test a strategy that permits obtaining, improving, and retaining new skills and knowledge needed to develop and use “Living evidence synthesis” among members of health system organizations in charge of developing KT products to inform health decisions.
The project was aimed at the professional members of different groups or organizations in charge of developing KT products (such as health technology assessment reports, evidence-based practice guidelines, and structured evidence summaries or policy briefs) to inform health decisions or to support health decision-makers in different settings. Therefore, we invited to participate different types of health system organizations (i.e. Scientific Societies; Health Technology Assessment [HTA] agencies; clinical practice guideline [CPG] developing organizations, and Health Care institutions (hospitals) involved in a working program for evidence-based decisions and practice in Spain [MAPAC program]). Through them, we invited members of their technical teams in charge of developing the evidence synthesis for the KT products.
Even though the research has not indicated any single design or set of approaches that guaranteed to succeed in building capacity and improving performance, the Living Evidence to inform health decisions project involved the elements that underpin the approach to capacity building in health research, such as the external context considerations, the stakeholder’s involvement, the consideration of institutional/organization rules, the capability and resources, the performance and adaptation. Because we worked with organizations that regularly develop evidence synthesis to inform health decisions as part of their work, so their members have previous knowledge and skills in the application of evidence synthesis methods, the capacity-building strategy focused on how to implement the necessary methodology and tools to include living evidence in the usual evidence synthesis developed for KT products.
The capacity-building strategy defined and assessed included a set of training workshops, followed by the development of a living evidence synthesis, in which participants applied the LE-IHD framework as well as the knowledge obtained in training workshops, to real-life diverse situations. Following the principle of “learning by doing” the participant organizations generated one living evidence synthesis (i.e. one PICO) as part of a KT product, they have commissioned.
The participant’s skill development was strengthened through the experience while we evaluated the LE-IHD framework performance. According to the particular interest of an organization, the KT products to be worked on could be: i) structured evidence summaries for institutional and/or public health policies; ii) health technology assessment reports, and iii) evidence-based recommendations for a CPG.
Even though the research has not indicated any single design or set of approaches that guaranteed to succeed in building capacity and improving performance, the Living Evidence to inform health decisions project involved the elements that underpin the approach to capacity building in health research, such as the external context considerations, the stakeholder’s involvement, the consideration of institutional/organization rules, the capability and resources, the performance and adaptation. Because we worked with organizations that regularly develop evidence synthesis to inform health decisions as part of their work, so their members have previous knowledge and skills in the application of evidence synthesis methods, the capacity-building strategy focused on how to implement the necessary methodology and tools to include living evidence in the usual evidence synthesis developed for KT products.
The capacity-building strategy defined and assessed included a set of training workshops, followed by the development of a living evidence synthesis, in which participants applied the LE-IHD framework as well as the knowledge obtained in training workshops, to real-life diverse situations. Following the principle of “learning by doing” the participant organizations generated one living evidence synthesis (i.e. one PICO) as part of a KT product, they have commissioned.
The participant’s skill development was strengthened through the experience while we evaluated the LE-IHD framework performance. According to the particular interest of an organization, the KT products to be worked on could be: i) structured evidence summaries for institutional and/or public health policies; ii) health technology assessment reports, and iii) evidence-based recommendations for a CPG.
The project generated different types of results:
Results related to the definition of the “Living evidence to inform health decisions framework” that includes:
a.Scientific publications on the construction process of the LE-IHD framework, and results of its evaluation as a tool to incorporate living evidence synthesis as part of the KT products.
b.The interactive web-based tool that will be available for the use of health sector organizations (available at https://living-evidence.epistemonikos.org/home(odnośnik otworzy się w nowym oknie))
Results related to the assessment of the capacity-building strategy used to support health sector organizations in the development of living evidence synthesis as part of their current process and tasks.
Results related to the clinical topics for which the new evidence syntheses were developed (i.e. Results directly related to the evidence syntheses completed by the project participants as defined in the work packages (WP 1, WP2, and WP 3)). These results include the following documents for each synthesis developed by the organizations:
a.The protocol of the synthesis
b.The baseline report
c.The evidence surveillance table/report
d.The updated report.
According to our knowledge, this is the first project that has developed a capacity-building strategy on living evidence methodology.
Results related to the definition of the “Living evidence to inform health decisions framework” that includes:
a.Scientific publications on the construction process of the LE-IHD framework, and results of its evaluation as a tool to incorporate living evidence synthesis as part of the KT products.
b.The interactive web-based tool that will be available for the use of health sector organizations (available at https://living-evidence.epistemonikos.org/home(odnośnik otworzy się w nowym oknie))
Results related to the assessment of the capacity-building strategy used to support health sector organizations in the development of living evidence synthesis as part of their current process and tasks.
Results related to the clinical topics for which the new evidence syntheses were developed (i.e. Results directly related to the evidence syntheses completed by the project participants as defined in the work packages (WP 1, WP2, and WP 3)). These results include the following documents for each synthesis developed by the organizations:
a.The protocol of the synthesis
b.The baseline report
c.The evidence surveillance table/report
d.The updated report.
According to our knowledge, this is the first project that has developed a capacity-building strategy on living evidence methodology.