A systematic review of proposed approaches and exercises conducted for prioritizing topics or questions for systematic reviews

Tags: Oral
Fadlallah R1, El-Harakeh A1, Bou-Karroum L1, Lotfi T2, Akl E1
1Center for Systematic Reviews on Health Policy and Systems Research, American University of Beirut, 2Global Evidence Synthesis Initiative (GESI) Secretariat, American University of Beirut

Background: conducting systematic reviews requires considerable efforts and resources. Therefore, groups or institutions funding or conducting those reviews need to work with policymakers and stakeholders on prioritizing the topics.

Objectives: to systematically review the literature for proposed approaches and exercises conducted to prioritize topics or questions for systematic reviews.

Methods: we searched Medline, CINAHL and Cochrane Library databases. We also manually searched Google Scholar and screened reference lists of included and relevant papers. We included papers describing either proposed approaches or exercises conducted to prioritize topics or questions for systematic reviews in any health-related area. We followed standard processes for study selection and data abstraction. We analyzed findings in a semi-quantitative way using an iterative process of review and refinement. The six analyzed concepts were: methods for development of prioritization approaches; steps of prioritization; generation of initial list of topics; stakeholder involvement; prioritization criteria; and output of conducted exercises.

Results: out of the 27,699 citations identified, 20 articles reporting on 18 studies met our inclusion criteria: four proposed approaches for prioritization, 11 conducted prioritization exercises, and three did both. The papers addressed the following areas: clinical (n = 9), public health (n = 1), health policy and systems (n = 3), or more than one (n = 5). Cochrane-affiliated entities published six (33%) of the included studies. Two of the approaches stood out as comprehensive and detailed: one focused on the equity lens while the other focused on health policy and systems. We categorized prioritization into 12 steps clustered in three phases (pre-prioritization, prioritization and post-prioritization). Less than half of the studies addressed the post-prioritization phase. The most frequently reported steps for generating initial lists of topics were stakeholders' input (89%) and literature review (78%). Seventeen studies involved or proposed involving stakeholders. We identified 11 stakeholder categories, with the most frequently reported category being researchers (72%). Fifty-five per cent of the studies reported including patients, the public, or community members. We also identified 25 prioritization criteria, clustered in 10 domains. The most frequently reported criteria were the public health burden of the problem, availability of relevant systematic reviews, and availability of relevant primary studies.

Conclusions: our findings can guide the work of researchers, funders, policymakers and other stakeholders seeking to prioritize topics or questions for systematic reviews. We discuss the implications for policy, practice and research.

Patient or healthcare consumer involvement: we examine and reflect on engaging patients, consumers and vulnerable populations in prioritizing topics or questions for systematic reviews.