An evidence synthesis programme commissioned by the UK’s National Institute for Health Research from two academic teams produced a diverse range of outputs and methodological insights in its first three years of operation. The programme was subsequently re-commissioned for two further cycles. Scoping the topic and involving stakeholders were key to its success.
Our 2019 Evidence & Policy paper summarised lessons learned from the experience of providing a responsive rapid evidence review facility for the UK National Institute for Health Research (NIHR) Health Services & Delivery Research (HSDR) programme. Teams from the Universities of York and Sheffield submitted successful bids in response to a call for expressions of interest, and three-year contracts ran from early 2014 to 2017. The table below briefly summarises the various covered; further details of methods and references to publications can be found in the paper (open access).
The paper contains numerous examples of how the teams worked with evidence users to address problems that arose in the course of the various projects and to increase dissemination and impact of the research. We have space to highlight just two of them here.
Example 1: refining scope following initial exploration of the topic
The York team’s review on integrated physical health care for people with SMI provides an example of modifying the scope of a review in the light of initial scoping work. The funding programme team initially suggested a set of broad questions about existing integrated care models and their evaluation but preliminary literature searches identified a recent systematic review that directly addressed this topic. The review team worked with expert advisors, including topic experts identified by the team and local service users, to refine the scope and produce a revised set of review questions. The revised scope looked beyond evaluative evidence to consider implementation issues noted by the advisors. In addition, while all evidence was interpreted in the context of the NHS, included evidence was not limited by country of origin.
Example 2: choosing between different areas of focus
The focus of a review was on TB contact tracing within specific population groups (‘hard to reach’ populations). However, initial literature searches revealed that the available evidence related to these groups comprised a small number of generally low-quality studies. The team therefore consulted stakeholders before undertaking further work. Stakeholders included national and local policymakers, infectious disease and public health practitioners, and the review commissioners. Three options were presented for discussion: widen the review to TB contact tracing in any population; examine contact tracing in specific populations for other conditions; and focus on two specific interventions (social network approaches and community workers). Consultation revealed a consensus that the first option was most promising. The review team therefore broadened the scope to include TB contact tracing in any population while retaining a focus on applicability of evidence to the specific population groups of interest.
Compared with other models for commissioning rapid evidence synthesis projects (that is, commissioning projects individually and evaluating researcher-led proposals, the evidence synthesis centre model offers the potential advantages of improved timeliness, relevance, flexibility and the potential for improved working relationships and collaboration. The re-commissioning of evidence synthesis teams for a second and third programme, as well as a similar review team in public health, supports the value of such teams as part of the national evidence and research infrastructure, supporting policy and decision-making at many different levels.
This work was supported by the NIHR HSDR programme under project number 13/05/12. The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HSDR programme or the Department of Health.
You can read the original research in Evidence & Policy:
Chambers, D. Booth, A. Rodgers, M. Preston, L. Dalton, J. Goyder, E. Thomas, S. Parker, G. Street and Eastwood, A. (2019). Evidence to support delivery of effective health services: a responsive programme of rapid evidence synthesis. Evidence & Policy, DOI: 10.1332/174426419X15468574223221. [Open Access]
Duncan Chambers is a Research Fellow in the School of Health and Related Research (ScHARR), University of Sheffield. He has over 15 years’ experience in evidence synthesis, including systematic reviews, health technology assessment, rapid reviews and overviews of reviews. Recent research has focused mainly on urgent care and digital delivery of healthcare.atthew Thomas Johnson, PhD, Senior Lecturer in Politics, Lancaster University. Politics, Philosophy and Religion, County South, Lancaster University.
Image credit: Image CC BY 2.0 – Open Knowledge Foundation
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