Article type
Abstract
Background: Visual impairment affects 2.2 billion people globally, with a prevalence 4 times higher in low- and middle-income countries (LMICs). Despite this, evidence on interventions to improve eye health in LMICs is scarce. To address this, Sightsavers developed eye health evidence gap maps (EGMs), a visual tool that presents the state of evidence from systematic reviews, providing easy access to available evidence and highlighting knowledge gaps. This presentation discusses the availability of evidence related to LMICs, using the diabetic retinopathy (DR) EGM as a case study.
Methods: The EGMs include evidence from systematic reviews identified through electronic literature searches. Reviews are selected using inclusion/exclusion criteria and assessed for relevance to LMICs by eye health experts. Data from each review are extracted, and the methodology is quality assessed using the SURE checklist, attributing an overall confidence level. Reviews are then populated into the EGM matrix developed by eye health clinicians and researchers from different LMICs. Clicking a hyperlink on the map takes you to a summary of that review, including discussion points on the generalizability and applicability of findings to LMICs.
Results: The DR EGM includes 124 reviews. Fifty-nine contain evidence from high-, middle-, and low-income countries (HMLICs); 34 did not report the geographic region of included evidence; 17 report on evidence from high-income settings only; and 14 report on evidence solely from LMICs. In the latter category, 10/14 studies report on the burden of disease, 3 address treatment, and 1 tackles screening of DR. Among the studies that include evidence from HMLICs, most reviews address screening (17), risk/prevention (15), treatment (14), and burden of DR (7). Clear gaps in evidence relevant to LMICs are observed in the broader sectors of DR-related health systems and quality of nonclinical care.
Conclusion: The EGMs are a useful tool to present relevant evidence in a user-friendly format for decision-makers working in LMICs. They allow for the implementation of interventions based on the most up-to-date and high-quality information relevant to their settings, show knowledge gaps, and monitor trends in the development of the evidence base.
Methods: The EGMs include evidence from systematic reviews identified through electronic literature searches. Reviews are selected using inclusion/exclusion criteria and assessed for relevance to LMICs by eye health experts. Data from each review are extracted, and the methodology is quality assessed using the SURE checklist, attributing an overall confidence level. Reviews are then populated into the EGM matrix developed by eye health clinicians and researchers from different LMICs. Clicking a hyperlink on the map takes you to a summary of that review, including discussion points on the generalizability and applicability of findings to LMICs.
Results: The DR EGM includes 124 reviews. Fifty-nine contain evidence from high-, middle-, and low-income countries (HMLICs); 34 did not report the geographic region of included evidence; 17 report on evidence from high-income settings only; and 14 report on evidence solely from LMICs. In the latter category, 10/14 studies report on the burden of disease, 3 address treatment, and 1 tackles screening of DR. Among the studies that include evidence from HMLICs, most reviews address screening (17), risk/prevention (15), treatment (14), and burden of DR (7). Clear gaps in evidence relevant to LMICs are observed in the broader sectors of DR-related health systems and quality of nonclinical care.
Conclusion: The EGMs are a useful tool to present relevant evidence in a user-friendly format for decision-makers working in LMICs. They allow for the implementation of interventions based on the most up-to-date and high-quality information relevant to their settings, show knowledge gaps, and monitor trends in the development of the evidence base.