Missing Pieces: Identifying the gaps in public health
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The document identifies gaps in public health evidence by analyzing the availability and quality of systematic reviews across various topics. It highlights that while certain areas are well-represented, others, including specific sub-topics and populations, lack sufficient review literature. Recommendations include prioritizing the creation of reviews where gaps exist and focusing funding on those areas.
Missing Pieces: Identifying the gaps in public health
- 1. Missing Pieces: Identifying the gaps in public health effectiveness evidence Daiva Tirilis, Hon B.A . (Health Studies) Lyndsey McRae, McMaster University Kara DeCorby, MSc Maureen Dobbins, RN, PhD Cochrane Symposium Ottawa, ON May 20, 2010
- 2. The Health Evidence Team Maureen Dobbins, Director Kara DeCorby, Project Coordinator Heather Husson Project Manager Tel: 905 525-9140 ext 22481 Tel: (905) 525-9140 ext. 20461 Tel: (905) 525-9140 ext. 20462 E-mail: E-mail: [email protected] E-mail: [email protected] [email protected] Paula Robeson Lori Greco Daiva Tirilis Lyndsey McRae Kathryn Spoelstra Knowledge Broker Knowledge Broker Research Assistant Research Assistant Research Assistant
- 3. Our Funders Cochrane Symposium Ottawa, ON May 20, 2010
- 4. A special thank you to the National Collaborating Centre for Methods and Tools for funding this Report Cochrane Symposium Ottawa, ON May 20, 2010
- 5. What is health-evidence.ca? A searchable, online registry of quality-rated review literature created to support public health and health promotion decision making. health-evidence.ca includes over 342 Cochrane reviews Cochrane Symposium Ottawa, ON May 20, 2010
- 6. Cochrane Symposium Ottawa, ON May 20, 2010
- 7. Background High-quality review evidence is crucial for evidence-informed decision making in public health given that they summarize what is known about a given intervention, thus provide a more accurate estimate of its effectiveness.1,2 Certain topic areas are poorly represented in the review literature 1. Chan, K.S., Morton, S.C., & Shekelle, P.G. (2004). Systematic reviews for evidence-based management: Howto find them and what to do with them. American Journal of Care Management, 10(11 part I), 806-812. 2. Howes, F., Doyle, J., Jackson, N., & Waters, E. (2004). Evidence-based public health: The importanc3e of finding ‘difficult to locate’ public health and health promotion intervention studies for systematic reviews. Journal of Public Health, 26(1), 101-104. Cochrane Symposium Ottawa, ON May 20, 2010
- 8. Objectives 1) To identify where gaps in systematic reviews evaluating public health interventions exist 2) To identify topics for which many reviews exist, and require a review of reviews Cochrane Symposium Ottawa, ON May 20, 2010
- 9. Methods Reviewed registry content by: 1) Topic Area 2) Population 3) Intervention Location 4) Intervention Strategy Determined proportion of reviews with strong, moderate or weak methodological quality Cochrane Symposium Ottawa, ON May 20, 2010
- 10. Cochrane Symposium Ottawa, ON May 20, 2010
- 11. Methods When discussing major topic areas Limited Reviews n = 1-100 Moderate Reviews n = 101-200 Many Reviews n = 201+ When discussing sub-topic areas Limited Reviews n = < 5 Moderate Reviews n = 5 – 20 Many Reviews n = 20+ Cochrane Symposium Ottawa, ON May 20, 2010
- 12. Results
- 13. EXCERPT Table 1: Overview of major topic headings KEYWORD TOTAL Strong Moderate Weak Focus of Review: Main Topic Areas (in alphabetical order) Addiction/Substance Use 268 129 66 69 Adolescent Health 251 120 58 73 Adult Health 400 205 105 90 Child Health 316 158 82 75 Chronic Diseases 477 253 104 118 Communicable Disease/Infection 195 108 45 42 Infant Health 122 72 27 23 Injury Prevention/Safety 226 138 51 36 Mental Health 220 119 57 44 Nutrition 283 156 66 61 Parenting, Infants and Children 232 130 54 47 Physical Activity 254 123 65 66 Reproductive Health 171 101 34 36 Senior Health 104 64 25 15 Sexual Health 151 74 39 36 Sexually Transmitted Infections 157 65 42 50
- 14. Ample Evidence Sub-topics with > 20 Reviews These 63 sub-topics included: Disease Transmission (32) Alcohol Abuse/Use (45) Healthy Weight (51) Smoking Cessation (74) Lifestyle Behaviours (145) Cochrane Symposium Ottawa, ON May 20, 2010
- 15. Missing Pieces Main Public Health Topics Areas in need of Reviews of Interventions Cochrane Symposium Ottawa, ON May 20, 2010
- 16. Missing Pieces Sub-Topics with < 5 Reviews These 135 sub-topic areas included: Lung Cancer Needle Exchange Oral Hygiene Food Service Inspection Poverty Reduction Eating Disorders Cochrane Symposium Ottawa, ON May 20, 2010
- 17. Missing Pieces Sub-Topics with 0 Reviews 43 sub-topics had no reviews: Asbestos Carbon Monoxide Poisoning Head lice/Pediculosis Air bags Botulism Food processing & Inspection Elder Abuse Cochrane Symposium Ottawa, ON May 20, 2010
- 18. Missing Pieces Study Populations Specific Cultural Groups (41) High-risk Groups (40) First Nations, Inuit and Metis (6) Cochrane Symposium Ottawa, ON May 20, 2010
- 19. Missing Pieces Intervention Locations Health Bus (1) Farms (5) Hospices (5) Family Centres (9) Camps (11) Restaurants (11) Day Care Centres (32) Health Departments (32) Cochrane Symposium Ottawa, ON May 20, 2010
- 20. Missing Pieces Intervention Strategies Emergency Preparedness (2) Surveillance (20) Public Health Inspection and Environmental Health (22) Advocacy (30) Cochrane Symposium Ottawa, ON May 20, 2010
- 21. Where are the high-quality reviews? Wide variation in the QUANTITY of reviews available for certain topics BUT In general 50% of the reviews available across topics were of high QUALITY Cochrane Symposium Ottawa, ON May 20, 2010
- 22. Conclusions 1. Author higher-level syntheses 2. Prioritize reviews where gaps exist 3. Focus funding Cochrane Symposium Ottawa, ON May 20, 2010
- 23. Future Initiatives Dissemination Higher-level Syntheses KT Capacity Development Cochrane Symposium Ottawa, ON May 20, 2010
- 24. Contact Information Maureen Dobbins 905 525-9140 ext 22481 [email protected] Lyndsey McRae [email protected] General Inquiries [email protected] Cochrane Symposium Ottawa, ON May 20, 2010