Transcript Document

Q u ic k T im e ™ a n d a
G r a p h ic s d e c o m p r e s s o r
a r e n e e d e d t o s e e t h is p ic t u r e .
putting research into context
Project Overview
Funded by
The Victorian Neurotrauma Initiative - 18 month project
Based at Melbourne University’s 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
Global Evidence Mapping (GEM) Initiative Project Structure
GEM Steering Committee
Advisory Groups
Prehospital (TBI & SCI)
Hospital TBI
Hospital SCI
Rehabilitation TBI
Rehabilitation SCI
Mapping
Search strategies
Critical Appraisal & synthesis
Information & Communications
Technology
Legend:
TAC Transport Accident Commission
VNI Victorian Neurotrauma Initiative
UoM University of Melbourne
RMH Royal Melbourne Hospital
TBI Traumatic Brain Injury
SCI Spinal Cord Injury
Russell Gruen (UoM,RMH,EPOC), Alex Collie
(TAC/VNI), Emma Tavender (NICS,EPOC), Sally Green
(ACC), Claire Harris (CCE), Heather Buchan & Jan
Davies (NICS), Andrew Kaye (UoM,RMH), Terry Harrison
(RMH), Peter Morley (RMH), Justin Zobel (NICTA), Don
Campbell (Monash)
GEM Working Group
Russell Gruen, Emma Tavender,
Project Manager: Ornella Clavisi
Project officers: Jason Wasiak, Marion Cincotta, Peter
Bragge, Loyal Pattuwage,
Medical Student: Pek Ghe Tan
Other Stakeholders
For example:
Faculty of Medicine,
Dentistry & Health
Sciences, UoM
Cochrane Collaboration
Nossal Institute for Global
Health
Consumer Groups
ACC Australasian Cochrane Centre , MISHR
CCE Centre for Clinical Effectiveness, MISHR
MISHR Monash Institute for Health Services Research
NICS National Institute of Clinical Studies (an Institute of the NH&MRC)
NICTA National Information and Communications Australia
EPOC Cochrane Effective Practice & Organisation of Care Group Australian satellite
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
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
Overview
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•
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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
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
Our Focus
• Traumatic Brain Injury & Spinal Cord Injury
• Prehospital, Hospital & Long Term Care
phases
• Currently working on the Pre-Hospital Phase
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
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
Develop Boundaries of the Map
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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
Context
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What contextual factors may significantly effect the feasibility of
managing a patient in a certain way
Environmental equipment resources staffing distance etc
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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
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
Website
www.evidencemap.org