Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
Int J Equity Health. 2017 Dec 2;16(1):208. doi: 10.1186/s12939-017-0697-5.
A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an 'equity lens' to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and apply an equity lens by developing a knowledge translation product comprising summaries of systematic reviews from the Cochrane Library. E4E translates evidence from systematic reviews into 'friendly front end' summaries for policy makers.
The following topic areas with high burdens of disease globally, were selected for the pilot: diabetes/obesity, HIV/AIDS, malaria, nutrition, and mental health/depression. For each topic area, a "stakeholder panel" was assembled that included policymakers and researchers. A systematic search of Cochrane reviews was conducted for each area to identify equity-relevant interventions with a meaningful impact. Panel chairs developed a rating sheet which was used by all panels to rank the importance of these interventions by: 1) Ease of Implementation; 2) Health System Requirements; 3)Universality/Generalizability/Share of Burden; and 4) Impact on Inequities/Effect on equity. The ratings of panel members were averaged for each intervention and criterion, and interventions were ordered according to the average overall ratings.
Stakeholder panels identified the top 10 interventions from their respective topic areas. The evidence on these interventions is being summarized with an equity focus and the results posted online, at http://methods.cochrane.org/equity/e4e-series .
This method provides an explicit approach to setting priorities by systematic review groups and funders for providing decision makers with evidence for the most important equity-relevant interventions.
健康公平已成为众多全球发展目标和报告、研究及国际宣言的关注重点。随着相关框架和方法的发展,坎贝尔和 Cochrane 公平方法小组鼓励将“公平视角”应用于系统评价,许多组织发布了旨在解决健康公平问题的评价。证据用于公平(E4E)项目旨在通过开发一个知识转化产品来开展优先排序工作并应用公平视角,该产品由 Cochrane 图书馆中的系统评价摘要组成。E4E 将系统评价中的证据转化为决策者友好的前端摘要。
本研究选择了全球疾病负担较高的以下专题领域进行试点:糖尿病/肥胖、HIV/AIDS、疟疾、营养和心理健康/抑郁。为每个专题领域都组建了一个利益相关者小组,其中包括决策者和研究人员。针对每个领域,进行了 Cochrane 评价的系统检索,以确定具有重要影响的公平相关干预措施。小组主席制定了一份评分表,供所有小组使用,根据以下标准对这些干预措施的重要性进行排名:1)实施的难易程度;2)卫生系统要求;3)普遍性/可推广性/负担分担;以及 4)对不公平的影响/对公平的影响。对每个干预措施和标准的小组成员的评分进行平均,并根据平均总体评分对干预措施进行排序。
利益相关者小组从各自的专题领域确定了前 10 项干预措施。正在对这些干预措施进行概述,并以公平为重点,将结果发布在在线网站 http://methods.cochrane.org/equity/e4e-series 上。
该方法为系统评价组和资助者提供了一种明确的方法,以便为决策者提供最重要的公平相关干预措施的证据,从而确定优先事项。