How effects on health equity are assessed in system­atic reviews of interventions: a Cochrane methodology systematic review

Tags: Poster
Welch V, Demontigny J, Ueffing E, Benghalti M, McGowan J, Petticrew M, Kristjansson E, Wells G, Tugwell P

Background: There is increasing interest in whether systematic reviews can contribute to the evidence-base on promoting health equity. Objectives: To systematically review methods used to assess effects on health equity in cohorts of systematic reviews of effectiveness. Methods: We searched MEDLINE (1950 to Jan 2008), PsycINFO, Cochrane Methodology Register (Issue 1, 2008), CINAHL (1982 to Apr 2008), SCOPUS, and handsearched the Campbell Collaboration presentations of 2007 and the citations of included studies. We included methodology reports that assessed one or more factors related to health equity in a cohort of systematic reviews. Risk of bias was appraised for selection, attrition and detection bias, using pre-determined questions. Data were extracted using a pre-tested form. Results: We included eight studies, six of which were based on groups of Cochrane reviews. Three methodological approaches to assessing effects on health equity were identified: 1) descriptive assessment of reporting and analysis in systematic reviews; 2) descriptive assessment of reporting and analysis in primary studies; and 3) analytic approaches. Data on sociodemographic factors were lacking for all three approaches. Cochrane reviews were disproportionately represented in the included studies. Conclusions: There is need for methodological guidance, based on empirical evidence, on how to assess effects on health equity in systematic reviews. These results will be updated by searching non-health databases, including Education Abstracts, Sociological Abstracts and Index to Legal Periodicals.