Petkovic Jennifer, Welch Vivian, Jacob Marie Helena, Yoganathan Manosila, Ayala Ana Patricia, Cunningham Heather, Tugwell Peter
Campbell Syst Rev. 2018 Sep 10;14(1):1-52. doi: 10.4073/csr.2018.8. eCollection 2018.
This review summarizes the evidence from six randomized controlled trials that judged the effectiveness of systematic review summaries on policymakers' decision making, or the most effective ways to present evidence summaries to increase policymakers' use of the evidence. This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one. The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary. None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?" Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews.
It is likely that evidence summaries are easier to understand than complete systematic reviews. Whether these summaries increase the use of evidence from systematic reviews in policymaking is not clear. Systematic reviews are long and technical documents that may be hard for policymakers to use when making decisions. Evidence summaries are short documents that describe research findings in systematic reviews. These summaries may simplify the use of systematic reviews.Other names for evidence reviews are , , , or . The goal of this review was to learn whether evidence summaries help policymakers use evidence from systematic reviews. This review also aimed to identify the best ways to present the evidence summary to increase the use of evidence. This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one.The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary.None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?"Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read.. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews. Our review suggests that evidence summaries help policymakers to better understand the findings presented in systematic reviews. In short, evidence summaries should be developed to make it easier for policymakers to understand the evidence presented in systematic reviews. However, right now there is very little evidence on the best way to present systematic review evidence to policymakers. The authors of this review searched for studies through June 2016.
EXECUTIVE SUMMARY/ABSTRACT: Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. Strategies to promote the use of evidence to decision makers are required, and evidence summaries have been suggested as a facilitator. Evidence summaries include policy briefs, briefing papers, briefing notes, evidence briefs, abstracts, summary of findings tables, and plain language summaries. There are many organizations developing and disseminating systematic review evidence summaries for different populations or subsets of decision makers. However, evidence on the usefulness and effectiveness of systematic review summaries is lacking. We present an overview of the available evidence on systematic review evidence summaries. This systematic review aimed to 1) assess the effectiveness of evidence summaries on policy-makers' use of the evidence and 2) identify the most effective summary components for increasing policy-makers' use of the evidence. We searched several online databases (Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Global Health Library, Popline, Africa-wide, Public Affairs Information Services, Worldwide Political Science Abstracts, Web of Science, and DfiD), websites of research groups and organizations which produce evidence summaries, and reference lists of included summaries and related systematic reviews. These databases were searched in March-April, 2016. Eligible studies included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies. We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of "evidence summary", "policy brief", or other product derived from systematic reviews that presented evidence in a summarized form. These interventions could be compared to active comparators (e.g. other summary formats) or no intervention.The primary outcomes were: 1) use of systematic review summaries decision-making (e.g. self-reported use of the evidence in policy-making, decision-making) and 2) policymaker understanding, knowledge, and/or beliefs (e.g. changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g. format) of the summaries. Our database search combined with our grey literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text and we included 6 studies (reported in 7 papers, 1661 participants) as well as protocols from 2 ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (4 studies) and perceived usefulness or usability (3 studies). Summary of Findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for Summary of Findings tables, certain elements, such as reporting study event rates and absolute differences were preferred as well as avoiding the use of footnotes. No studies assessed adverse effects. The risks of bias in these studies were mainly assessed as unclear or low however, two studies were assessed as high risk of bias for incomplete outcome data due to very high rates of attrition. Evidence summaries may be easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear.
本综述总结了六项随机对照试验的证据,这些试验评估了系统综述摘要对政策制定者决策的有效性,或呈现证据摘要以增加政策制定者对证据使用的最有效方式。本综述纳入了六项随机对照研究。随机对照研究是指将参与者随机(通过随机方式)分为不同组,以比较不同治疗方法或其他干预措施。这种分组方法意味着各小组将具有相似性,并且对他们所接受治疗的效果进行比较会更加公平。在研究进行时,尚不清楚哪种治疗方法更好。开展这些研究的研究人员邀请了来自欧洲、北美、南美、非洲和亚洲的人参与。两项研究关注“政策简报”,一项研究关注“证据摘要”,两项研究关注“结果总结表”,一项研究将“结果总结表”与证据摘要进行了比较。这些研究均未考察政策制定者在决策过程中如何直接使用系统综述中的证据,但有两项研究发现,他们使用这些摘要的方式几乎没有差异。这些研究依赖于决策者的报告。这些研究包括诸如“这个摘要是否易于理解?”等问题。一些研究考察了使用者的知识、理解、信念,或者他们认为这些摘要的可信度(可靠性)。在考察这些结果的研究中几乎没有差异。研究参与者对分级录入格式的可用性评价高于完整的系统综述。分级录入格式允许读者选择他们想要阅读的信息量。研究参与者认为所有证据摘要格式都比完整的系统综述更容易理解。
证据摘要可能比完整的系统综述更容易理解。这些摘要是否能增加政策制定中对系统综述证据的使用尚不清楚。系统综述是冗长且技术性很强的文件,政策制定者在做决策时可能难以使用。证据摘要则是描述系统综述研究结果的简短文件。这些摘要可能会简化系统综述的使用。证据综述的其他名称有政策简报、简报文件、简报笔记、证据简报、摘要、结果总结表或通俗易懂的总结。本综述的目的是了解证据摘要是否有助于政策制定者使用系统综述中的证据。本综述还旨在确定呈现证据摘要以增加证据使用的最佳方式。本综述纳入了六项随机对照研究。随机对照研究是指将参与者随机(通过随机方式)分为不同组,以比较不同治疗方法或其他干预措施。这种分组方法意味着各小组将具有相似性,并且对他们所接受治疗的效果进行比较会更加公平。在研究进行时,尚不清楚哪种治疗方法更好。开展这些研究的研究人员邀请了来自欧洲、北美、南美、非洲和亚洲的人参与。两项研究关注“政策简报”,一项研究关注“证据摘要”,两项研究关注“结果总结表”,一项研究将“结果总结表”与证据摘要进行了比较。这些研究均未考察政策制定者在决策过程中如何直接使用系统综述中的证据,但有两项研究发现,他们使用这些摘要的方式几乎没有差异。这些研究依赖于决策者的报告。这些研究包括诸如“这个摘要是否易于理解?”等问题。一些研究考察了使用者对摘要的知识、理解、信念,或者他们认为这些摘要的可信度(可靠性)。在考察这些结果的研究中几乎没有差异。研究参与者对分级录入格式的可用性评价高于完整的系统综述。分级录入格式允许读者选择他们想要阅读的信息量。研究参与者认为所有证据摘要格式都比完整的系统综述更容易理解。我们的综述表明,证据摘要有助于政策制定者更好地理解系统综述中呈现的研究结果。简而言之,应开发证据摘要,以便政策制定者更容易理解系统综述中呈现的证据。然而,目前关于向政策制定者呈现系统综述证据的最佳方式的证据非常少。本综述的作者检索研究至2016年6月。
执行摘要/摘要:系统综述对决策者很重要。它们有许多潜在益处,但通常用技术语言撰写,篇幅过长,且不包含背景细节,这使得它们难以用于决策。需要采取策略来促进向决策者提供证据的使用,证据摘要被认为是一种促进手段。证据摘要包括政策简报、简报文件、简报笔记、证据简报、摘要、结果总结表和通俗易懂的总结。有许多组织为不同人群或决策者子集开发和传播系统综述证据摘要。然而,缺乏关于系统综述摘要的有用性和有效性的证据。我们概述了关于系统综述证据摘要的现有证据。本系统综述旨在:1)评估证据摘要对政策制定者使用证据的有效性;2)确定增加政策制定者对证据使用的最有效摘要组成部分。我们检索了几个在线数据库(Medline、EMBASE、CINAHL、Cochrane对照试验中央注册库、全球健康图书馆、Popline、全非洲、公共事务信息服务、世界政治科学摘要、科学引文索引和国际发展部)、产生证据摘要的研究小组和组织的网站,以及纳入摘要和相关系统综述的参考文献列表。这些数据库于2016年3月至4月进行了检索。符合条件的研究包括随机对照试验(RCT)、非随机对照试验(NRCT)、前后对照研究(CBA)和中断时间序列(ITS)研究。我们纳入了各级政策制定者以及卫生系统管理者的研究。我们纳入了考察任何类型的“证据摘要”、“政策简报”或其他源自系统综述并以总结形式呈现证据的产品的研究。这些干预措施可与积极对照(如其他摘要格式)或无干预进行比较。主要结果为:1)在决策中使用系统综述摘要(如在政策制定中自我报告的证据使用情况、决策情况);2)政策制定者的理解、知识和/或信念(如关于摘要中包含主题的知识得分变化)。我们还评估了摘要的感知相关性、可信度、有用性、可理解性和可取性(如格式)。我们的数据库检索与灰色文献检索相结合,在去除重复项后产生了10113条参考文献。其中,54篇进行了全文评审,我们纳入了6项研究(发表在7篇论文中,1661名参与者)以及2项正在进行研究的方案。两项研究评估了证据摘要在决策中的使用情况,发现效果几乎没有差异。在知识、理解或信念方面(4项研究)以及感知有用性或可用性方面(3项研究)效果也几乎没有差异。与完整的系统综述相比,结果总结表和分级录入摘要被认为稍微更容易理解。两项研究评估了格式变化,发现对于结果总结表,某些元素,如报告研究事件发生率和绝对差异更受青睐,同时应避免使用脚注。没有研究评估不良反应。这些研究中的偏倚风险主要被评估为不清楚或低,然而,有两项研究由于极高的失访率被评估为因结果数据不完整而存在高偏倚风险。证据摘要可能比完整的系统综述更容易理解。然而,它们在政策制定中增加系统综述证据使用的能力尚不清楚。