Prioritising Cochrane reviews to be updated with health equity focus

Eve Tomlinson; Jordi Pardo Pardo; Torunn Sivesind; Mindy D. Szeto; Melissa Laughter; Ruth Foxlee; Michael Brown; Nicole Skoetz; Robert P. Dellavalle; Juan VA Franco; Mike Clarke; Alison Krentel; Ludovic Reveiz; Ashrita Saran; Frances Tse; George A Wells; Robert J Boyle; Jennifer Hilgart; Euphrasia Ebai Atuh Ndi; Vivian Welch; Jennifer Petkovic; Peter Tugwell

doi:10.1186/s12939-023-01864-z

Prioritising Cochrane reviews to be updated with health equity focus

Eve Tomlinson^*, Jordi Pardo Pardo, Torunn Sivesind, Mindy D. Szeto, Melissa Laughter, Ruth Foxlee, Michael Brown, Nicole Skoetz, Robert P. Dellavalle, Juan VA Franco, Mike Clarke, Alison Krentel, Ludovic Reveiz, Ashrita Saran, Frances Tse, George A Wells, Robert J Boyle, Jennifer Hilgart, Euphrasia Ebai Atuh Ndi, Vivian WelchJennifer Petkovic, Peter Tugwell

^*Corresponding author for this work

Bristol Medical School (PHS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

2 Citations (Scopus)

Abstract

Background

The prioritisation of updating published systematic reviews of interventions is vital to prevent research waste and ensure relevance to stakeholders. The consideration of health equity in reviews is also important to ensure interventions will not exacerbate the existing inequities of the disadvantaged if universally implemented. This study aimed to pilot a priority setting exercise based on systematic reviews of interventions published in the Cochrane Library, to identify and prioritise reviews to be updated with a focus on health equity.

Methods

We conducted a priority setting exercise with a group of 13 international stakeholders. We identified Cochrane reviews of interventions that showed a reduction in mortality, had at least one Summary of Findings table and that focused on one of 42 conditions with a high global burden of disease from the 2019 WHO Global Burden of Disease report. This included 21 conditions used as indicators of success of the United Nations Universal Health Coverage in attaining the Sustainable Development Goals. Stakeholders prioritised reviews that were relevant to disadvantaged populations, or to characteristics of potential disadvantage within the general population.

Results

After searching for Cochrane reviews of interventions within 42 conditions, we identified 359 reviews that assessed mortality and included at least one Summary of Findings table. These pertained to 29 of the 42 conditions; 13 priority conditions had no reviews with the outcome mortality. Reducing the list to only reviews showing a clinically important reduction in mortality left 33 reviews. Stakeholders ranked these reviews in order of priority to be updated with a focus on health equity.

Conclusions

This project developed and implemented a methodology to set priorities for updating systematic reviews spanning multiple health topics with a health equity focus. It prioritised reviews that reduce overall mortality, are relevant to disadvantaged populations, and focus on conditions with a high global burden of disease. This approach to the prioritisation of systematic reviews of interventions that reduce mortality provides a template that can be extended to reducing morbidity, and the combination of mortality and morbidity as represented in Disability-Adjusted Life Years and Quality-Adjusted Life Years.

Original language	English
Article number	81
Number of pages	11
Journal	International Journal for Equity in Health
Volume	22
DOIs	https://doi.org/10.1186/s12939-023-01864-z
Publication status	Published - 12 May 2023

Bibliographical note

Funding Information:
LR has declared that no competing interests exist. Authors hold sole responsibility for the views expressed in the manuscript, which may not necessarily reflect the opinion or policy of the Pan American Health Organization. RPD is Joint Coordinating Editor of Cochrane Skin, Cochrane Council Co-Chair, and Director of the University of Colorado US Cochrane Affiliate. MC is Coordinating Editor of the Cochrane Methodology Review Group and Podcast Editor for the Cochrane Library. RF is the Senior Programme Manager in the Cochrane Editorial Methods Department, providing in-kind support from Cochrane on the pilot. EEAN is a Cochrane Consumer Executive. ET worked for Cochrane at the time of conducting this work. PT is funded by the Canada Research Chair Program. JPP is a Managing Editor of Cochrane Musculoskeletal.

Publisher Copyright:
© 2023, The Author(s).

Keywords

Cochrane
Health equity
Prioritisation
Priority setting
Systematic review

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Tomlinson, E., Pardo Pardo, J., Sivesind, T., Szeto, M. D., Laughter, M., Foxlee, R., Brown, M., Skoetz, N., Dellavalle, R. P., VA Franco, J., Clarke, M., Krentel, A., Reveiz, L., Saran, A., Tse, F., A Wells, G., Boyle, R. J., Hilgart, J., Ndi, E. E. A., ... Tugwell, P. (2023). Prioritising Cochrane reviews to be updated with health equity focus. International Journal for Equity in Health, 22, Article 81. https://doi.org/10.1186/s12939-023-01864-z

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title = "Prioritising Cochrane reviews to be updated with health equity focus",

abstract = "BackgroundThe prioritisation of updating published systematic reviews of interventions is vital to prevent research waste and ensure relevance to stakeholders. The consideration of health equity in reviews is also important to ensure interventions will not exacerbate the existing inequities of the disadvantaged if universally implemented. This study aimed to pilot a priority setting exercise based on systematic reviews of interventions published in the Cochrane Library, to identify and prioritise reviews to be updated with a focus on health equity.MethodsWe conducted a priority setting exercise with a group of 13 international stakeholders. We identified Cochrane reviews of interventions that showed a reduction in mortality, had at least one Summary of Findings table and that focused on one of 42 conditions with a high global burden of disease from the 2019 WHO Global Burden of Disease report. This included 21 conditions used as indicators of success of the United Nations Universal Health Coverage in attaining the Sustainable Development Goals. Stakeholders prioritised reviews that were relevant to disadvantaged populations, or to characteristics of potential disadvantage within the general population.ResultsAfter searching for Cochrane reviews of interventions within 42 conditions, we identified 359 reviews that assessed mortality and included at least one Summary of Findings table. These pertained to 29 of the 42 conditions; 13 priority conditions had no reviews with the outcome mortality. Reducing the list to only reviews showing a clinically important reduction in mortality left 33 reviews. Stakeholders ranked these reviews in order of priority to be updated with a focus on health equity.ConclusionsThis project developed and implemented a methodology to set priorities for updating systematic reviews spanning multiple health topics with a health equity focus. It prioritised reviews that reduce overall mortality, are relevant to disadvantaged populations, and focus on conditions with a high global burden of disease. This approach to the prioritisation of systematic reviews of interventions that reduce mortality provides a template that can be extended to reducing morbidity, and the combination of mortality and morbidity as represented in Disability-Adjusted Life Years and Quality-Adjusted Life Years.",

keywords = "Cochrane, Health equity, Prioritisation, Priority setting, Systematic review",

author = "Eve Tomlinson and {Pardo Pardo}, Jordi and Torunn Sivesind and Szeto, {Mindy D.} and Melissa Laughter and Ruth Foxlee and Michael Brown and Nicole Skoetz and Dellavalle, {Robert P.} and {VA Franco}, Juan and Mike Clarke and Alison Krentel and Ludovic Reveiz and Ashrita Saran and Frances Tse and {A Wells}, George and Boyle, {Robert J} and Jennifer Hilgart and Ndi, {Euphrasia Ebai Atuh} and Vivian Welch and Jennifer Petkovic and Peter Tugwell",

note = "Funding Information: LR has declared that no competing interests exist. Authors hold sole responsibility for the views expressed in the manuscript, which may not necessarily reflect the opinion or policy of the Pan American Health Organization. RPD is Joint Coordinating Editor of Cochrane Skin, Cochrane Council Co-Chair, and Director of the University of Colorado US Cochrane Affiliate. MC is Coordinating Editor of the Cochrane Methodology Review Group and Podcast Editor for the Cochrane Library. RF is the Senior Programme Manager in the Cochrane Editorial Methods Department, providing in-kind support from Cochrane on the pilot. EEAN is a Cochrane Consumer Executive. ET worked for Cochrane at the time of conducting this work. PT is funded by the Canada Research Chair Program. JPP is a Managing Editor of Cochrane Musculoskeletal. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = may,

day = "12",

doi = "10.1186/s12939-023-01864-z",

language = "English",

volume = "22",

journal = "International Journal for Equity in Health",

issn = "1475-9276",

publisher = "BioMed Central",

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Tomlinson, E, Pardo Pardo, J, Sivesind, T, Szeto, MD, Laughter, M, Foxlee, R, Brown, M, Skoetz, N, Dellavalle, RP, VA Franco, J, Clarke, M, Krentel, A, Reveiz, L, Saran, A, Tse, F, A Wells, G, Boyle, RJ, Hilgart, J, Ndi, EEA, Welch, V, Petkovic, J & Tugwell, P 2023, 'Prioritising Cochrane reviews to be updated with health equity focus', International Journal for Equity in Health, vol. 22, 81. https://doi.org/10.1186/s12939-023-01864-z

TY - JOUR

T1 - Prioritising Cochrane reviews to be updated with health equity focus

AU - Tomlinson, Eve

AU - Pardo Pardo, Jordi

AU - Sivesind, Torunn

AU - Szeto, Mindy D.

AU - Laughter, Melissa

AU - Foxlee, Ruth

AU - Brown, Michael

AU - Skoetz, Nicole

AU - Dellavalle, Robert P.

AU - VA Franco, Juan

AU - Clarke, Mike

AU - Krentel, Alison

AU - Reveiz, Ludovic

AU - Saran, Ashrita

AU - Tse, Frances

AU - A Wells, George

AU - Boyle, Robert J

AU - Hilgart, Jennifer

AU - Ndi, Euphrasia Ebai Atuh

AU - Welch, Vivian

AU - Petkovic, Jennifer

AU - Tugwell, Peter

N1 - Funding Information: LR has declared that no competing interests exist. Authors hold sole responsibility for the views expressed in the manuscript, which may not necessarily reflect the opinion or policy of the Pan American Health Organization. RPD is Joint Coordinating Editor of Cochrane Skin, Cochrane Council Co-Chair, and Director of the University of Colorado US Cochrane Affiliate. MC is Coordinating Editor of the Cochrane Methodology Review Group and Podcast Editor for the Cochrane Library. RF is the Senior Programme Manager in the Cochrane Editorial Methods Department, providing in-kind support from Cochrane on the pilot. EEAN is a Cochrane Consumer Executive. ET worked for Cochrane at the time of conducting this work. PT is funded by the Canada Research Chair Program. JPP is a Managing Editor of Cochrane Musculoskeletal. Publisher Copyright: © 2023, The Author(s).

PY - 2023/5/12

Y1 - 2023/5/12

N2 - BackgroundThe prioritisation of updating published systematic reviews of interventions is vital to prevent research waste and ensure relevance to stakeholders. The consideration of health equity in reviews is also important to ensure interventions will not exacerbate the existing inequities of the disadvantaged if universally implemented. This study aimed to pilot a priority setting exercise based on systematic reviews of interventions published in the Cochrane Library, to identify and prioritise reviews to be updated with a focus on health equity.MethodsWe conducted a priority setting exercise with a group of 13 international stakeholders. We identified Cochrane reviews of interventions that showed a reduction in mortality, had at least one Summary of Findings table and that focused on one of 42 conditions with a high global burden of disease from the 2019 WHO Global Burden of Disease report. This included 21 conditions used as indicators of success of the United Nations Universal Health Coverage in attaining the Sustainable Development Goals. Stakeholders prioritised reviews that were relevant to disadvantaged populations, or to characteristics of potential disadvantage within the general population.ResultsAfter searching for Cochrane reviews of interventions within 42 conditions, we identified 359 reviews that assessed mortality and included at least one Summary of Findings table. These pertained to 29 of the 42 conditions; 13 priority conditions had no reviews with the outcome mortality. Reducing the list to only reviews showing a clinically important reduction in mortality left 33 reviews. Stakeholders ranked these reviews in order of priority to be updated with a focus on health equity.ConclusionsThis project developed and implemented a methodology to set priorities for updating systematic reviews spanning multiple health topics with a health equity focus. It prioritised reviews that reduce overall mortality, are relevant to disadvantaged populations, and focus on conditions with a high global burden of disease. This approach to the prioritisation of systematic reviews of interventions that reduce mortality provides a template that can be extended to reducing morbidity, and the combination of mortality and morbidity as represented in Disability-Adjusted Life Years and Quality-Adjusted Life Years.

AB - BackgroundThe prioritisation of updating published systematic reviews of interventions is vital to prevent research waste and ensure relevance to stakeholders. The consideration of health equity in reviews is also important to ensure interventions will not exacerbate the existing inequities of the disadvantaged if universally implemented. This study aimed to pilot a priority setting exercise based on systematic reviews of interventions published in the Cochrane Library, to identify and prioritise reviews to be updated with a focus on health equity.MethodsWe conducted a priority setting exercise with a group of 13 international stakeholders. We identified Cochrane reviews of interventions that showed a reduction in mortality, had at least one Summary of Findings table and that focused on one of 42 conditions with a high global burden of disease from the 2019 WHO Global Burden of Disease report. This included 21 conditions used as indicators of success of the United Nations Universal Health Coverage in attaining the Sustainable Development Goals. Stakeholders prioritised reviews that were relevant to disadvantaged populations, or to characteristics of potential disadvantage within the general population.ResultsAfter searching for Cochrane reviews of interventions within 42 conditions, we identified 359 reviews that assessed mortality and included at least one Summary of Findings table. These pertained to 29 of the 42 conditions; 13 priority conditions had no reviews with the outcome mortality. Reducing the list to only reviews showing a clinically important reduction in mortality left 33 reviews. Stakeholders ranked these reviews in order of priority to be updated with a focus on health equity.ConclusionsThis project developed and implemented a methodology to set priorities for updating systematic reviews spanning multiple health topics with a health equity focus. It prioritised reviews that reduce overall mortality, are relevant to disadvantaged populations, and focus on conditions with a high global burden of disease. This approach to the prioritisation of systematic reviews of interventions that reduce mortality provides a template that can be extended to reducing morbidity, and the combination of mortality and morbidity as represented in Disability-Adjusted Life Years and Quality-Adjusted Life Years.

KW - Cochrane

KW - Health equity

KW - Prioritisation

KW - Priority setting

KW - Systematic review

U2 - 10.1186/s12939-023-01864-z

DO - 10.1186/s12939-023-01864-z

M3 - Article (Academic Journal)

C2 - 37147653

SN - 1475-9276

VL - 22

JO - International Journal for Equity in Health

JF - International Journal for Equity in Health

M1 - 81

ER -

Prioritising Cochrane reviews to be updated with health equity focus

Abstract

Bibliographical note

Keywords

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