CubecXpert, Quebec City, QC, Canada.
Department of Social and Preventive Medicine, Université Laval, Quebec City, QC, Canada.
Health Res Policy Syst. 2022 Mar 24;20(1):34. doi: 10.1186/s12961-022-00830-5.
The last decade has seen growing interest in scaling up of innovations to strengthen healthcare systems. However, the lack of appropriate methods for determining their potential for scale-up is an unfortunate global handicap. Thus, we aimed to review tools proposed for assessing the scalability of innovations in health.
We conducted a systematic review following the COSMIN methodology. We included any empirical research which aimed to investigate the creation, validation or interpretability of a scalability assessment tool in health. We searched Embase, MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library and ERIC from their inception to 20 March 2019. We also searched relevant websites, screened the reference lists of relevant reports and consulted experts in the field. Two reviewers independently selected and extracted eligible reports and assessed the methodological quality of tools. We summarized data using a narrative approach involving thematic syntheses and descriptive statistics.
We identified 31 reports describing 21 tools. Types of tools included criteria (47.6%), scales (33.3%) and checklists (19.0%). Most tools were published from 2010 onwards (90.5%), in open-access sources (85.7%) and funded by governmental or nongovernmental organizations (76.2%). All tools were in English; four were translated into French or Spanish (19.0%). Tool creation involved single (23.8%) or multiple (19.0%) types of stakeholders, or stakeholder involvement was not reported (57.1%). No studies reported involving patients or the public, or reported the sex of tool creators. Tools were created for use in high-income countries (28.6%), low- or middle-income countries (19.0%), or both (9.5%), or for transferring innovations from low- or middle-income countries to high-income countries (4.8%). Healthcare levels included public or population health (47.6%), primary healthcare (33.3%) and home care (4.8%). Most tools provided limited information on content validity (85.7%), and none reported on other measurement properties. The methodological quality of tools was deemed inadequate (61.9%) or doubtful (38.1%).
We inventoried tools for assessing the scalability of innovations in health. Existing tools are as yet of limited utility for assessing scalability in health. More work needs to be done to establish key psychometric properties of these tools. Trial registration We registered this review with PROSPERO (identifier: CRD42019107095).
过去十年，人们对扩大创新以加强医疗体系的兴趣日益浓厚。然而，缺乏适当的方法来确定其扩大规模的潜力是一个不幸的全球性障碍。因此，我们旨在回顾用于评估卫生创新可扩展性的工具。
我们按照 COSMIN 方法进行了系统回顾。我们纳入了任何旨在研究可扩展性评估工具的创建、验证或可解释性的实证研究。我们从创建之日起在 Embase、MEDLINE、CINAHL、Web of Science、PsycINFO、Cochrane 图书馆和 ERIC 进行了搜索，直至 2019 年 3 月 20 日。我们还搜索了相关网站，筛选了相关报告的参考文献，并咨询了该领域的专家。两名审查员独立选择并提取了合格的报告，并评估了工具的方法学质量。我们使用涉及主题综合和描述性统计的叙述方法总结数据。
我们确定了 31 份报告，描述了 21 种工具。工具类型包括标准（47.6%）、量表（33.3%）和清单（19.0%）。大多数工具是在 2010 年以后出版的（90.5%），来自开放获取资源（85.7%），并由政府或非政府组织资助（76.2%）。所有工具均为英文；其中 4 种（19.0%）被译为法语或西班牙语。工具的创建涉及单一（23.8%）或多种（19.0%）类型的利益相关者，或没有报告利益相关者的参与（57.1%）。没有研究报告涉及患者或公众，也没有报告工具创建者的性别。工具的创建用于高收入国家（28.6%）、低收入或中等收入国家（19.0%）或两者兼有（9.5%），或用于将创新从低收入或中等收入国家转移到高收入国家（4.8%）。卫生保健水平包括公共或人群健康（47.6%）、初级保健（33.3%）和家庭护理（4.8%）。大多数工具仅提供关于内容有效性的有限信息（85.7%），并且没有报告其他测量特性。工具的方法学质量被认为是不充分的（61.9%）或可疑的（38.1%）。
我们对评估卫生创新可扩展性的工具进行了编目。现有的工具在评估卫生方面的可扩展性方面还远远不够。需要做更多的工作来建立这些工具的关键心理测量特性。试验注册我们在 PROSPERO（标识符：CRD42019107095）中对本综述进行了注册。
