Article type
Abstract
Background: As part of a broader evidence synthesis project to update the vector control for malaria prevention guidelines in partnership with the Global Malaria Programme of the World Health Organization, the importance of having evidence for contextual factors related to a recommendation was highlighted.
Objective: We seek to demonstrate how evidence and gap maps (EGMs) can be used in the development of a guideline to inform future planning and decision-making, particularly in relation to the criteria within the GRADE evidence-to-decision framework (ETDF).
Methods: We produced an EGM to identify where evidence had been published that addressed contextual factors considered in the GRADE ETDF, the methodology of the evidence, where and when this evidence was published, and other important identifying features.
Results: Our EGM detailed that while many studies had been produced over the last 40 years that investigated vector-control interventions and contextual factors important to decision-making, the vast majority of these were focused on the contextual factors of "acceptability" and "feasibility" from the perspective of the patient, with fewer studies providing data from the perspective of the provider. Very few studies were available that provided any data in regards to the "valuation of the outcomes of interest." There was also a significant disparity observed in the methodology of studies available in this space.
Conclusion: Our EGM demonstrated that on the surface, there appears to be a vast amount of evidence available to inform the development of guidelines. However, when visualized through the EGM it becomes apparent that this evidence is methodologically diverse, addresses specific and unique perspectives, and is otherwise in an unsuitable and significantly heterogenous format that precludes systematic review to be undertaken. This work can demonstrate what areas of the GRADE ETDF can be informed by appropriate systematic review of the evidence and what specific areas need additional high-quality primary research investment for the betterment of the public.
Objective: We seek to demonstrate how evidence and gap maps (EGMs) can be used in the development of a guideline to inform future planning and decision-making, particularly in relation to the criteria within the GRADE evidence-to-decision framework (ETDF).
Methods: We produced an EGM to identify where evidence had been published that addressed contextual factors considered in the GRADE ETDF, the methodology of the evidence, where and when this evidence was published, and other important identifying features.
Results: Our EGM detailed that while many studies had been produced over the last 40 years that investigated vector-control interventions and contextual factors important to decision-making, the vast majority of these were focused on the contextual factors of "acceptability" and "feasibility" from the perspective of the patient, with fewer studies providing data from the perspective of the provider. Very few studies were available that provided any data in regards to the "valuation of the outcomes of interest." There was also a significant disparity observed in the methodology of studies available in this space.
Conclusion: Our EGM demonstrated that on the surface, there appears to be a vast amount of evidence available to inform the development of guidelines. However, when visualized through the EGM it becomes apparent that this evidence is methodologically diverse, addresses specific and unique perspectives, and is otherwise in an unsuitable and significantly heterogenous format that precludes systematic review to be undertaken. This work can demonstrate what areas of the GRADE ETDF can be informed by appropriate systematic review of the evidence and what specific areas need additional high-quality primary research investment for the betterment of the public.