Co-producing a Cochrane qualitative evidence synthesis: applying real-world perspectives to full-text screening

Article type
Authors
Merner B1, Hill S1, Lowe D1, Walsh L1, Wardrope C2, Colombo C3, Gaulden CM4, Graham-Wisener L5, Xafis V6, Schonfeld L1, Bryden P7, Chmielewski R8, Martin F9, Menzies D10, Refahi N11, Sonawane R12
1Centre for Health Communication and Participation, La Trobe University
2 Patient Safety and Quality Service, Children’s Health Queensland Hospital and Health Service, South Brisbane
3Laboratory for medical research and consumer involvement, Department of Public Health, Istituto di Ricerche Farmacologiche, Mario Negri IRCCS, Milano
4Detroit Wayne County Authority Health Residency Program, Michigan State University, Providence Hospital, Southfield, Michigan
5School of Psychology, Queen’s University Belfast
6Centre for Biomedical Ethics, National University of Singapore and The Sydney Children’s Hospitals Network, Westmead
7Consumer and carer representative, Queensland
8Planning and Patient Experience, The Royal Victorian Eye and Ear Hospital, East Melbourne
9CatholicCare, East Melbourne
10South Eastern Melbourne Primary Health Network, Victoria
11Consumer representative, Victoria
12Rockingham General Hospital and Wexford Specialist Clinics, Murdoch
Abstract
Background: Cochrane’s Knowledge Translation framework includes co-production as a key means of delivering reviews that meet users’ needs. Most systematic review co-production methods focus on involving stakeholders in topic selection and results interpretation; involvement in screening is less common.

In 2017, we began co-producing a Cochrane qualitative evidence synthesis with a national Australian stakeholder panel, purposively selected for involvement from three groups: consumers (n = 6), clinicians (n = 6) and health decision-makers (n = 6). During protocol stage, the entire panel contributed to topic selection and designing the selection criteria, and many became protocol co-authors. Given the stakeholders’ enthusiasm, we decided to develop a method for co-producing the full-text screening step.

Objectives:
1) to develop and pilot a co-production method for full-text screening
2) to assess the contribution of co-production in this method to the relevance of the review

Methods: we invited stakeholders to participate in a full-text screening event. Eleven of 18 stakeholders agreed to participate (4/11 were consumers or carers).

At the event:
1) we assigned stakeholders to groups, each with at least one consumer, clinician and health decision-maker;
2) facilitated by a researcher, each group applied the selection criteria to different
qualitative research papers;
3) following discussion, we reached consensus about the eligibility of each study.

After the event, we emailed additional articles to stakeholders wanting to complete further screening.

Results: in total, stakeholders screened over 140 articles. A researcher independently 'second-screened' each article, showing a high level of agreement.

A post-event survey showed 9 of 11 stakeholders strongly agreed that the resources used during the event helped them to contribute to the screening process.

The multi-faceted health system experiences of stakeholders helped the researchers improve how they applied the selection criteria, so the studies selected would reflect 'real-world' practice. For example, stakeholders noted that the researchers were narrowly applying one of the selection criteria resulting in the exclusion of studies highly relevant to their health services. Researchers subsequently broadened the scope of this criterion.

Conclusions: this co-production method was successful in involving stakeholders in review production and resulted in changes likely to improve the relevance of the review.

Consumer involvement: four consumers or carers