let's talk research annual conference - 24th-25th september 2014 (professor rumona dickson)
TRANSCRIPT
Objectives
General information regarding systematic reviewing and
evidence synthesis
CLAHRC – Collaboration for Leadership in Applied Health
Research and Care – Applying for funds to do a systematic review
– Proposed CPD programme in evidence synthesis and implementation
Evidence synthesis
Historical perspective
Review methodology
Developing research questions
“Systematic reviews locate, appraise and
synthesise evidence from scientific studies in
order to provide informative empirical
answers to scientific research questions”
(Deeks et al, 1996)
EVIDENCE-BASED HEALTH CARE
“The conscientious, explicit and judicious use of
current best evidence in making decisions about the
care of individual patients. The practice of evidence-
based [medicine] means integrating individual clinical
expertise with the best available external clinical
evidence from systematic research” (Sackett et al,
1996)
Historical Perspective
Cochrane Collaboration
Working together to help healthcare practitioners, policy-makers, patients, their
advocates and carers, make well-informed decisions about health care, by preparing,
updating, and promoting the accessibility of Cochrane Reviews
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The Campbell Collaboration (C2) helps people make well-informed decisions by preparing, maintaining and
disseminating systematic reviews in education, crime and justice, social welfare and
international development
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Evolution of reviewing methods
Synthesis of qualitative data – Sandolowski
http://eprints.ncrm.ac.uk/468/1/1007_JTAHthematic_synthesis.pdf
– Scottish guidelines
http://www.healthcareimprovementscotland.org/programmes/clinical__cost_effectiveness/pro
gramme_resources/synth_qualitative_research.aspx
– Centre for Reviews and Dissemination (CRD) University of York
http://www.york.ac.uk/inst/crd/index_guidance.htm
Realist synthesis – CARES – Centre for the Advancement of Realist Evaluation and Synthesis
http://www.liv.ac.uk/psychology-health-and-society/research/cares/
– Ray Pawson
http://www.ccsr.ac.uk/methods/publications/documents/RMPmethods2.pdf
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Challenge to health care professionals
Accessing the information
Interpreting/appraising the information
Implementing the evidence
Systematic review activities
Development of research question and protocol
Searching
Application of inclusion criteria
Quality assessment
Data extraction and presentation
Synthesis
Research question - PICO
Population
Intervention
Comparator
Outcome
Other review questions - PICo
Population
Phenomena of Interest
Context
Joanna Briggs Institute, 2011
Research protocol – a must
Would anyone be allowed to conduct a randomised
controlled trial or other research without a protocol?
For some reason people think that they do not need a
protocol for a systematic review!!
Searching
Databases – how many – how far back
Internet – Google Scholar
Hand searching (computer TOC)
Contacting experts
Managing results
ScHARR – qualitative data searching
E Exploratory methods. Include search terms related to the methodology of interest, such as focus group, grounded
theory, action research
S Software: Include search terms related to software researchers may have used to analyze their data, such as NVivo
or Nudist
C Citations: Include key references, both in your specific research area and more globally in the qualitative research
arena
A Application: Consider searching terms related to the wider application of potentially relevant studies, such as
ethnology or psychology
P Phenomenon: Include search terms related to the phenomenon of interest, such as perceptions, attitudes, view
points, standpoints
A Approaches: Consider searching for different methodological approaches, such as ethnography
D Data: Think how researchers may have ‘labelled’ their data in their paper and include terms such as stories,
narratives, themes
E Experiences: Similarly, consider how researchers may have conceptualised participants’ experiences, using terms
such as encounters
Applying inclusion criteria
Who does it
Doing it independently
Doing it in stages
)
Quality assessment
Question - Which is the right tool?
Answer – IT depends
Quality assessment tools
Sources – General – CASP http://www.phru.nhs.uk/casp/casp.htm
– http://www.shef.ac.uk/scharr/ir/netting/
RCT – CONSORT statement – Moher, D., Schulz, K., Altman, D. and Group, a. t. C. (2001) The CONSORT
statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA, 285, 1987-1991.
Systematic reviews – PRISMA document – http://www.prisma-statement.org/
What do you do with the results of the QA
Most people don‟t do anything
Sensitivity analysis
Substantiate decisions related to data synthesis
Data extraction and presentation
Tables describe
Text discusses
Sample of tables
Quality assessment
Study characteristics
Participant characteristics
Outcomes
Document production
Good preparation leads to good performance
It always takes longer than you think
Discussion and conclusions
Need time to „absorb‟ data to write these (unless you wrote them before the review)
Developing a review question
Clinical question – What works best
Process question – How to do what works best
Resource available.
CLAHRC
Collaboration for Leadership in Applied Health Research and
Care – North West Coast
42 Partners – CCGs, HEIs, Local Authorities
Focus on health inequalities and patient and public involvement
Five themes – Evidence synthesis, mental health, complex need, personalised medicine and knowledge
exchange
Evidence Synthesis activities – Support the conduct of reviews (funded research)
– CPD for implementation of change
Evidence synthesis – funding application
CPD Programme
Work in teams to:
undertake an evidence synthesis project
gain organisational support
influence, implement and evaluate practice change in the
workplace
Blended learning programme
Over 12 months:
4 sequenced interactive workshops interspersed with -
distance learning support
mentor/supervisor support
action within the workplace
peer support and action learning sets
Evidence Synthesis Information Events
9th October, Lancaster University
22nd October, Best Western, Leyland
27th November, University of Liverpool
http://www.clahrc-nwc.nihr.ac.uk/news-events.php
