putting research into context

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putting research into context
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Project Overview
Funded by The Victorian Neurotrauma Initiative -
18 month project Based at Melbourne Universitys
Dept Surgery Collaborators Royal Melbourne
Hospital The University of Melbourne
Australasian Cochrane Centre National Institute
of Clinical Studies (NICS) National Information
and Communications Australia (NICTA) Monash
University Southern Health

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Aim of the map

• To improve the accessibility and usefulness of
  research evidence in health care
• The maps will be global in that they encompass
  whole clinical areas, include all published and
  ongoing research, and will be relevant to a
  diverse international community

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Overview

• Develop evidence maps of research evidence within
  broad clinical areas to convey
• what research exists
• where the gaps are
• the strengths and weaknesses of existing
  research
• its relevance to different users in a range of
  contexts

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Overview

• Develop maps of research questions about many
  different treatments, diagnostic tests,
  prognosis, and issues of cost-effectiveness and
  the organisation delivery of services.
• For each question we plan to achieve a complete
  inventory of primary studies and systematic
  reviews
• Using systematic review methods we will appraise
  and characterize each study
• Summarize the evidence

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Overview

• Evidence mapping ?Systematic reviews
• Evidence mapping ? Evidence practice
  guidelines
• Evidence map gaps identify gaps guide the
  future development of these and future primary
  research

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Our Focus

• Traumatic Brain Injury Spinal Cord Injury
• Prehospital, Hospital Long Term Care phases
• Currently working on the Pre-Hospital Phase

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Methodology

• Review Methodology
• Two stages
• Stage 1 Searching, selection, classification
  and data extraction (study characteristics and
  results),
• Stage 2 Summarizing evidence, reporting on
  consistency of results and magnitude, and
  evidence gaps
• Developing predefined selection
• Types of studies
• Patient group
• Intervention/test/prognostic factors etc
• Phase

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Methodology

• Search Methods for the identification of studies
• Search strategy
• Medical databases (English and non English)
• Clinical trial and research registries
• Study Characteristics
• Data extraction Type of study, patient group,
  intervention comparator, outcome etc
• Quality assessment
• Use standardised tools (NICE, NHMRC) according to
  study design
• Brief Summary of the evidence
• Quantity of evidence, types of study design,
  ongoing studies, evidence gaps

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Develop Boundaries of the Map

• Evidence Mapping Workshops with health care
  providers directly involved in patient care
• We hope to identify the key clinical areas,
  outcomes, patient factors and contextual factors
  which clinicians feel should be part of the map

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Context

• What contextual factors may significantly effect
  the feasibility of managing a patient in a
  certain way
• Environmental equipment resources staffing
  distance etc
• Are there other interventions which might be more
  appropriate given a different context
• Do the outcome measures change (i.e. become more
  or less meaningful) if the context changes

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Where we are now

• Currently identified approx 40 questions to
  populate the map
• Refine and set a boundary for 15-20
• Currently in the process of searching and study
  selection
• Data extraction

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The Map

• Develop an IT platform for the map
• Searchable using key word in a Wiki format
• Living map - users will be able to contribute and
  build the map
• Adapted for all clinical specialties
• What will this look like ??????

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The Map
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Website

www.evidencemap.org