Using existing systematic reviews to identify the evidence gaps for resilient health systems: a novel methodology

Article type
Authors
Pizarro AB1, Mansilla C2, Allen C3, Cuervo LG4, Clark M5
1Clinical Research Center, Fundación Valle del Lili, Cali
2Mc Master University
3Evidence Aid
4Health Systems and Services, PAHO
5MRC Methodology Hub, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast
Abstract
Background: Identifying evidence gaps that need to be filled is a critical step in conducting research. This helps provide the scientific, ethical, and environmental justification for new research and minimizes research waste. As part of a project funded by the Pan American Health Organization to develop an open-access evidence collection of summaries of systematic reviews (SRs) relevant to the resilience of health systems in the context of health emergency and disaster risk management (Health EDRM), Evidence Aid developed a novel methodology to identify evidence gaps through the use of existing SRs. This presentation outlines this methodology and its application.

Methods: SRs relevant to resilient health systems were identified in prioritized domains. Their implications for research were extracted, along with information about the review’s search date, geographical restrictions, area of uncertainty (e.g., effects of interventions and size of the problem), and type of research needed. Each gap was classified as to whether it would need to be filled by higher-quality research (generally or for specific populations or settings) or additional SRs. To assess if the gap identified in a review had already been filled by more recent research, we conducted an updated search using the review’s search strategy. We used colored visualizations to present the information.

Results: Twenty-four SRs of relevance to resilient health systems were prioritized and included. These covered four domains: chemical, biological, radiological, and nuclear hazards; migrants; hospital preparedness; and noncommunicable diseases. Most of the reviews had search dates in 2015-2020 and included 10-29 studies. We identified 34 evidence gaps from the SR. We found 11 more recent studies that might contribute to filling the gaps, leaving 23 evidence topics that remain in need of research.

Conclusions: Identification of evidence gaps is a critical step in research production, to better orient actions of researchers, funders, and evidence users. Our novel methodology identified evidence gaps in a given topic via the implications for research in SRs and updated searches. We show how the application of this methodology allows the identification of several critical gaps in the evidence for resilient health systems.

Patient, public and/or healthcare consumer involvement: N/A.