formulating research question for systematic reviews...best practice is to engage stakeholders,...
TRANSCRIPT
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Dr. Ashrita SaranEvidence Synthesis Specialist, Campbell Collaboration
Formulating research question for systematic reviews
@campbellreviews @AshritaSaran
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General idea Interest review question
What is your potential idea?
Agricultural input subsidies
What about this interests you?
I think what interests me about are agricultural input subsidies
effective? Does it have an impact on productivity and growth?
Tentative REVIEW QUESTION:What is the effectiveness of agricultural input
subsidies for improvingproductivity, farm income, consumer welfare
andwider growth in low- and lower-middle-income
countries: a systematic review
Now I’ve got a question, I’m off to a really great start.
For Systematic reviews
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General idea Interest review question
What is your potential idea?
Agricultural Innovations
What about this interests you?
What is the evidence of on the effect of agricultural innovation
interventions such as provision of inputs, financial assistance etc.What are the existing gaps in
evidence?
Tentative TOPIC:Agricultural Innovations: An
evidence and gap map
Now I’ve got a question, I’m off to a really great start.
For Evidence and Gap Map
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Formulating review question
Well-formulated questions will guide many aspects of the review/Evidence and Gap Map process:
• Searching strategy
• Inclusion/exclusion criteria
• Data extraction
• Choice of synthesis method
• Presentation/dissemination of findings
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Process: setting the context
Best practice is to engage stakeholders, including users, in setting the question, possibly through an advisory group. The AG can be asked questions such as:
– Does the review question sound interesting and useful to its target audience?
– What interventions should be included in the review?
– Which populations should be included in the review and which should be excluded?
– Are there specific sub-groups of interest which should be investigated in the review What types of outcomes should the review include?
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• Population(s)
• Intervention(s)
• Comparison(s)
• Outcome(s)
• Study design(s)
PICOS for Intervention reviews
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1. Identify the relevant Population
Is it People?
• Farmers?
• Welfare recipients?
• Teenage parents
• Crime victims?
• Disadvantaged families?
• Organisational employees?
Is it Places?
• Farms?
• Communities?
• Organisations?
Consider eligibility
criteria. WHO, WHAT
& WHERE?
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2. Identify a clear Intervention
• May be a ‘branded’ program or a set of conceptually ‘like’ interventions
– Children & Families: supplemental nutrition, Parenting interventions, Breakfast Clubs
– Farmers: Agricultural input subsidies, financial help– Older people: assistance at home, health insurance– Refugees: Brain Bank, Parent School Connect programs,
Refugee Action Program– Working and learning programs…and the list goes on!
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3. Identify a comparison
• Active or passive control
• Studies where the control group receives no intervention, placement on a wait-list. Also included studies comparing two treatments without reference to a no-intervention, wait-list or business as usual control group.
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4. Specify Outcomes
• What exactly does the intervention aim to change? Generic outcomes can
encompass many finer grained outcomes
• Is it feasible that the intervention will impact the outcome?
• Is it measurable? You must be able to clearly operationaliseyour outcome
Psychosocial
Wellbeing
Mental Health
Social Support
Employment
Safety
Stable HousingHappy
Relationships
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5. Study design
What study design should be included
• Randomised controlled trials
• Regression discontinuity designs
• Quasi-experimental, cross-sectional, cohort or panel designs that use multiple regression analysis and control for some combination of pre-intervention control variables
• Matched control group designs (with or without baseline measurement)
• Unmatched control group designs (with or without baseline measurement)
• Time-series designs
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Research question for systematic review
• The research question reflected in title and generally uses the following format:
[Intervention] for [Improving/Reducing/Increasing etc] [Outcome(s)] [Compared to other intervention] in [Population]: A systematic review of [study design]
The effectiveness of contract farming for raising income of smallholder farmers in low- and middle-income countries: A systematic review of RCT
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Working example of systematic review
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PICOS: an example
Farmer field schools for improving farming practices and farmer outcomes in low- and middle-income countries
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PICOS: an example
Farmer field schools for improving farming practices and farmer outcomes in low- and middle-income countries
Population: Farmers
Intervention: Farmer field school
Comparison: not indicated
Outcome: farming and farmer outcomes
Study design: Not indicated
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Another Example
The Impact of Land Property Rights Interventions on Agricultural Productivity in Developing Countries: A
Systematic Review
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Effectiveness reviews: PICOS for road safety
PICO Examples
Population Smallholders and communities in rural farming
systems
Population sub-group: women and men, age, social
status
Region: L&MICs;
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Effectiveness reviews: PICOS for road safety
PICO ExamplesPopulation Smallholders and communities in rural farming systems
Population sub-group: women and men, age, social status
Region: L&MICs;
Intervention adjudicating and assigning land rights
physically surveying boundaries
registering rights and boundary demarcations in an
official land registry
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Effectiveness reviews: PICOS for road safety
PICO ExamplesPopulation Smallholders and communities in rural farming systems
Population sub-group: women and men, age, social status
Region: L&MICs;
Intervention adjudicating and assigning land rights
physically surveying boundaries
registering rights and boundary demarcations in an official land registry
Comparator Active or passive control
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Effectiveness reviews: PICOS for road safety
PICO ExamplesPopulation Smallholders and communities in rural farming systems
Population sub-group: women and men, age, social status
Region: L&MICs;
Intervention adjudicating and assigning land rights
physically surveying boundaries
registering rights and boundary demarcations in an official land registry
Comparator Active or passive control
Outcomes Productivity of land use, welfare of pre-policy
landholders, measured in terms of income and
consumption, domestic violence, and gender
equity, welfare of post-policy landholders
measured in the same way.
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Effectiveness reviews: PICOS for road safety
PICO ExamplesPopulation Smallholders and communities in rural farming systems
Population sub-group: women and men, age, social status
Region: L&MICs;
Intervention adjudicating and assigning land rights
physically surveying boundaries
registering rights and boundary demarcations in an official land registry
Comparator Active or passive control
Outcomes Productivity of land use, welfare of pre-policy landholders, measured in terms of income and
consumption, domestic violence, and gender equity, welfare of post-policy landholders
measured in the same way.
Study
designs
Randomised Controlled Trial
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Working example of Evidence and Gap Map
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For Evidence and Gap Map
• The research question reflected in title and generally uses the following format:
{Intervention or problem for} and {Population} or {location/situation} or {outcome}: an evidence and gap map {of study type/design}.
Interventions for promoting uptake of safe water, sanitation, and hygiene for consumption at home, schools and health facilities in low- and middle-income countries: an evidence gap map
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Type of research question
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Systematic reviewing is an approach. It can be applied to a broad range of questions
Types of question
• Effectiveness
• Association / correlation
• Process / implementation
• Descriptive
• Prevalence
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Type of question
Review type Aim Question Format Example
Effectiveness To evaluate the effectiveness of a certain treatment/practice in terms of its impact on outcome
Population, Intervention, Comparator/s, Outcomes, study design(PICOS)
Effects of certification schemes for agricultural production on socio-economic outcomes in low- and middle-income countries: a systematic review
Prevalence To determine the prevalence of a certain condition
Condition, Context,Population (CoCoPop)
Prevalence of substance abuse amongst youth aged 15-21
Associational (correlation) analysis
To determine the association between an intervention and its impact
Population (including animal species), Exposure, Comparator, and Outcomes (PECO)
Predictors of youth gang membership in low- and middle-income countries
Barriers & facilitators (qualitative)
To investigate the barriers and facilitators to implementing an intervention
Population, Phenomena of Interest, Context (PICo)
Factors inhibiting adoption of improved seed varieties
Cost-effectiveness To determine the costs associated with a particular approach/treatment strategy, particularly in terms of cost effectiveness or benefit
Population, Intervention, Comparator/s, Outcomes, context(PICOC)
What is the cost effectiveness of self-monitoring of blood glucose in type 2 diabetes mellitus in high income countries?
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Different types of EGM for different research questions
Type Examples
Effectiveness Effectiveness of Interventions for People with Disabilities in Low- and Middle-Income Countries: An Evidence and Gap Map
Implementation
Global evidence and gap map of implementation issues for homelessness (This Implementation EGM contains evaluations with valuable qualitative evidence on what are called ‘barriers’ and ‘facilitators’)
Country EGM An evidence and gap map of development evaluations conducted in Uganda 2000-18
Methods,metric and tools
Evidence and Gap Map: Innovative methods and metrics in agricultural-nutrition research.
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EGMs can be applied to range of research question
Some examples: (Varies in scope and content)
• Map of Maps
• Mega Map
• Effectiveness Map (Homelessness)
• Homelessness Process map
• Uganda country EGM
• IMMANA EGM (methods and metrics)
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Map of Maps for the
Effectiveness of International
Development Interventions:
Scope and methodology
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• Evidence and gap map
• Extra-extra large scope: all of
international development
• Includes only EGMs
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55 completed
and 18 on-
going EGMs
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Next steps from
Map of Maps
Use map to identify
priority Evidence
and Gap Maps
Resulting maps being produced by CEDIL:
• Disability
• Transport
• Access to justice
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Mega map on child welfare in
low and middle income
countries:
a map of systematic reviews
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• Evidence and gap map
• Large scope: all of child welfare (health,
nutrition, education, child protection…)
• Includes EGMs and Systematic reviews
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Next steps from Mega Map
• Social work / child abuse
• Governance / child rights / trafficking
• Equity
UNICEF
commissioned
violence
against
children EGM
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Evidence and Gap
Homelessness effectiveness
map
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• Evidence and gap map
• Includes effectiveness studies
• Critical appraisal of all included studies
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A section of the homelessness effectiveness map
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Next steps/developments
from the map
• Identification of additional studies
• Evidence summaries for interventions
• Commissioning mixed methods systematic
reviews
On-going reviews
identified using
studies identified in
evidence maps
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Evidence and Gap Map-
Process Evaluation-Barriers
and Facilitators
(Homelessness)
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• Evidence and gap map
• Scope: homelessness process
evaluations(nearly all is grey literature
obtained through website searches not
database searches)
• Columns are barriers and facilitators,
not outcomes
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A section of the homelessness ‘facilitator’ map
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Next steps/developments
from the homelessness maps
• Evidence summaries for interventions
• Commissioning mixed methods systematic
reviews
Building
intervention tool
(evidence portal)
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Evidence and Gap Map-
Uganda Country EGM
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• Evidence and gap map
• Scope: all evaluations in Uganda from
2000-present day
• Includes all evaluation studies: Process
evaluations, impact evaluations and
formative evaluations
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The Uganda country evidence and map269 process evaluations, 207 impact evaluations and 7 formative evaluations
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Developments/Next steps
Commission more evaluations in the
areas of evident gaps
Country-level synthesis in areas with a lot
of evidence
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Scope: setting the question
The Goldilocks principle
Scope: how wide (specificity)?
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How do we achieve world peace?
That one’s
too big
(broad)
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How do we reduce traffic congestion in New Delhi?
That one’s
too little
(narrow)
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The effects of school voucher programmes on student attendance and attainment in low- and
middle-income countries
That one’s
just right
for
systematic
review
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The effectiveness of interventions for those affected by and at risk of homelessness in high-
income countries
That one’s
just right
for an EGM
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Group Exercise
• Write down a question for a systematic review or the scope of an evidence map.
• Identify the PICOS
• We will discuss the PICOS for each groups.
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