Background: There is a need for guidance on how knowledge users can apply the results from Campbell and Cochrane reviews to disadvantaged groups. Knowledge users are under pressure to consider the effects of policies and programs on health equity.

Objectives: To develop an extrapolation checklist to help decision-makers and practitioners decide when the results from systematic reviews are applicable to disadvantaged populations/settings.

Methods: We developed an extrapolation checklist by drawing on items from existing checklists and consulting healthcare practitioners, researchers, consumers and policy-makers. We held a pilot session with Cochrane methodologists, review authors, and staff to test this extrapolation checklist with specific scenarios which asked them to apply results of Cochrane reviews to specific disadvantaged populations (e.g. women, people in low- and middle-income countries, the poor). We then refined the checklist and the scenarios.

Results: We created 2 checklists: one for populations (to be used by policy-makers) and one for patients (to be used by practitioners). Feedback during a workshop and from one-on-one consultations suggested further refinement to operationalize the checklists as a decision aid, to take into account the relative and absolute effects, quality of evidence, values of the intended recipients of the intervention (population or patients), and other issues such as costs.

Conclusions: Our work suggests that using a systematic review involves complex decisions which could benefit from structured decision support tools, similar to decision support tools developed for patients.