Browsing by Author "Tugwell, Peter"

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    A taxonomy and framework for identifying and developing actionable statements in guidelines suggests avoiding informal recommendations
    (2022) Lotfi, Tamara; Hajizadeh, Anisa; Moja, Lorenzo; Akl, Elie A.; Piggott, Thomas; Kredo, Tamara; Langendam, Miranda W.; Iorio, Alfonso; Klugar, Miloslav; Klugarova, Jitka; Neumann, Ignacio; Wiercioch, Wojtek; Leontiadis, Grigorios, I; Mbuagbaw, Lawrence; Turgeon, Alexis F.; Meerpohl, Joerg; Stevens, Adrienne; Brozek, Jan; Santesso, Nancy; Pottie, Kevin; Dewidar, Omar; Flottorp, Signe A.; Karpusheff, Justine; Saz-Parkinson, Zuleika; Rojas, Maria X.; Parmelli, Elena; Chu, Derek K.; Tugwell, Peter; Welch, Vivian; Avey, Marc T.; Brignardello-Petersen, Romina; Mathew, Joseph L.; Munn, Zachary; Nieuwlaat, Robby; Ford, Nathan; Qaseem, Amir; Askie, Lisa M.; Schunemann, Holger J.
    Objective: To propose a taxonomy and framework that identifies and presents actionable statements in guidelines.
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    Development of a checklist to guide equity considerations in health technology assessment
    (2021) Benkhalti, Maria; Espinoza, Manuel; Cookson, Richard; Welch, Vivian; Tugwell, Peter; Dagenais, Pierre
    Objectives. Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step.
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    Equity issues rarely addressed in the development of COVID-19 formal recommendations and good practice statements: a cross-sectional study
    (2023) Dewidar, Omar; Bondok, Mostafa; Abdelrazeq, Leenah; Aliyeva, Khadija; Solo, Karla; Welch, Vivian; Brignardello-Petersen, Romina; Mathew, Joseph L.; Hazlewood, Glen; Pottie, Kevin; Hartling, Lisa; Khalifa, Dina Sami; Duda, Stephanie; Falavigna, Maicon; Khabsa, Joanne; Lotfi, Tamara; Petkovic, Jennifer; Elliot, Sarah; Chi, Yuan; Parker, Roses; Kristjansson, Elizabeth; Riddle, Alison; Darzi, Andrea J.; Magwood, Olivia; Saad, Ammar; Radav, Gabriel; Neumann, Ignacio; Loeb, Mark; Reveiz, Ludovic; Mertz, Dominik; Piggott, Thomas; Turgeon, Alexis F.; Schunemann, Holger; Tugwell, Peter
    Background and Objective: To identify COVID-19 actionable statements (e.g., recommendations) focused on specific disadvantaged populations in the living map of COVID-19 recommendations (eCOVIDRecMap) and describe how health equity was assessed in the development of the formal recommendations. Methods: We employed the place of residence, race or ethnicity or culture, occupation, gender or sex, religion, education, socio-economic status, and social capital-Plus framework to identify statements focused on specific disadvantaged populations. We assessed health equity considerations in the evidence to decision frameworks (EtD) of formal recommendations for certainty of evidence and impact on health equity criteria according to the Grading of Recommendations, Assessment, Development, and Evaluations criteria.Results: We identified 16% (124/758) formal recommendations and 24% (186/819) good practice statements (GPS) that were focused on specific disadvantaged populations. Formal recommendations (40%, 50/124) and GPS (25%, 47/186) most frequently focused on children. Seventy-six percent (94/124) of the recommendations were accompanied with EtDs. Over half (55%, 52/94) of those considered indirectness of the evidence for disadvantaged populations. Considerations in impact on health equity criterion most frequently involved implementation of the recommendation for disadvantaged populations (17%, 16/94). Conclusion: Equity issues were rarely explicitly considered in the development COVID-19 formal recommendations focused on specific disadvantaged populations. Guidance is needed to support the consideration of health equity in guideline development during health emergencies.& COPY; 2023 Elsevier Inc. All rights reserved.
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    Extending the PRISMA. statement to equity-focused systematic reviews (PRISMA-E. 2012) : explanation and elaboration
    (2016) Welch, Vivian; Petticrew, Mark; Petkovic, Jennifer; Moher, David; Waters, Elizabeth; White, Howard; Tugwell, Peter; Pantoja Calderón, Tomás
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    Improving Social Justice in COVID-19 Health Research: Interim Guidelines for Reporting Health Equity in Observational Studies
    (2021) Antequera, Alba; Lawson, Daeria O.; Noorduyn, Stephen G.; Dewidar, Omar; Avey, Marc; Bhutta, Zulfiqar A.; Chamberlain, Catherine; Ellingwood, Holly; Francis, Damian; Funnell, Sarah; Ghogomu, Elizabeth; Greer-Smith, Regina; Horsley, Tanya; Juando-Prats, Clara; Jull, Janet; Kristjansson, Elizabeth; Little, Julian; Nicholls, Stuart G.; Nkangu, Miriam; Petticrew, Mark; Rada, Gabriel; Rizvi, Anita; Shamseer, Larissa; Sharp, Melissa K.; Tufte, Janice; Tugwell, Peter; Verdugo-Paiva, Francisca; Wang, Harry; Wang, Xiaoqin; Mbuagbaw, Lawrence; Welch, Vivian
    The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes.
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    Improving social justice in observational studies: protocol for the development of a global and Indigenous STROBE-equity reporting guideline
    (2023) Funnell, Sarah; Jull, Janet; Mbuagbaw, Lawrence; Welch, Vivian; Dewidar, Omar; Wang, Xiaoqin; Lesperance, Miranda; Ghogomu, Elizabeth; Rizvi, Anita; Akl, Elie A.; Avey, Marc T.; Antequera, Alba; Bhutta, Zulfiqar A.; Chamberlain, Catherine; Craig, Peter; Cuervo, Luis G.; Dicko, Alassane; Ellingwood, Holly; Feng, Cindy; Francis, Damian; Greer-Smith, Regina; Hardy, Billie-Jo; Harwood, Matire; Hatcher-Roberts, Janet; Horsley, Tanya; Juando-Prats, Clara; Kasonde, Mwenya; Kennedy, Michelle; Kredo, Tamara; Krentel, Alison; Kristjansson, Elizabeth; Langer, Laurenz; Little, Julian; Loder, Elizabeth; Magwood, Olivia; Mahande, Michael J.; Melendez-Torres, G. J.; Moore, Ainsley; Niba, Loveline L.; Nicholls, Stuart G.; Nkangu, Miriam N.; Lawson, Daeria O.; Obuku, Ekwaro; Okwen, Patrick; Pantoja Calderón, Tomás; Petkovic, Jennifer; Petticrew, Mark; Pottie, Kevin; Rader, Tamara; Ramke, Jacqueline; Riddle, Alison; Shamseer, Larissa; Sharp, Melissa; Shea, Bev; Tanuseputro, Peter; Tugwell, Peter; Tufte, Janice; Von Elm, Erik; Waddington, Hugh S.; Wang, Harry; Weeks, Laura; Wells, George; White, Howard; Wiysonge, Charles S.; Wolfenden, Luke; Young, Taryn
    Background Addressing persistent and pervasive health inequities is a global moral imperative, which has been highlighted and magnified by the societal and health impacts of the COVID-19 pandemic. Observational studies can aid our understanding of the impact of health and structural oppression based on the intersection of gender, race, ethnicity, age and other factors, as they frequently collect this data. However, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline, does not provide guidance related to reporting of health equity. The goal of this project is to develop a STROBE-Equity reporting guideline extension. Methods We assembled a diverse team across multiple domains, including gender, age, ethnicity, Indigenous background, disciplines, geographies, lived experience of health inequity and decision-making organizations. Using an inclusive, integrated knowledge translation approach, we will implement a five-phase plan which will include: (1) assessing the reporting of health equity in published observational studies, (2) seeking wide international feedback on items to improve reporting of health equity, (3) establishing consensus amongst knowledge users and researchers, (4) evaluating in partnership with Indigenous contributors the relevance to Indigenous peoples who have globally experienced the oppressive legacy of colonization, and (5) widely disseminating and seeking endorsement from relevant knowledge users. We will seek input from external collaborators using social media, mailing lists and other communication channels. Discussion Achieving global imperatives such as the Sustainable Development Goals (e.g., SDG 10 Reduced inequalities, SDG 3 Good health and wellbeing) requires advancing health equity in research. The implementation of the STROBE-Equity guidelines will enable a better awareness and understanding of health inequities through better reporting. We will broadly disseminate the reporting guideline with tools to enable adoption and use by journal editors, authors, and funding agencies, using diverse strategies tailored to specific audiences.
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    Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses
    (2023) Tugwell, Peter; Welch, Vivian; Magwood, Olivia; Todhunter-Brown, Alex; Akl, Elie A.; Concannon, Thomas W.; Khabsa, Joanne; Morley, Richard; Schunemann, Holger; Lytvyn, Lyubov; Agarwal, Arnav; Antequera, Alba; Avey, Marc T.; Campbell, Pauline; Chang, Christine; Chang, Stephanie; Dans, Leonila; Dewidar, Omar; Ghersi, Davina; Graham, Ian D.; Hazlewood, Glen; Hilgart, Jennifer; Horsley, Tanya; John, Denny; Jull, Janet; Maxwell, Lara J.; McCutcheon, Chris; Munn, Zachary; Nonino, Francesco; Pardo, Jordi Pardo; Parker, Roses; Pottie, Kevin; Rada, Gabriel; Riddle, Alison; Synnot, Anneliese; Ghogomu, Elizabeth Tanjong; Tomlinson, Eve; Toupin-April, Karine; Petkovic, Jennifer
    BackgroundInvolving collaborators and partners in research may increase relevance and uptake, while reducing health and social inequities. Collaborators and partners include people and groups interested in health research: health care providers, patients and caregivers, payers of health research, payers of health services, publishers, policymakers, researchers, product makers, program managers, and the public. Evidence syntheses inform decisions about health care services, treatments, and practice, which ultimately affect health outcomes.Our objectives are to:A. Identify, map, and synthesize qualitative and quantitative findings related to engagement in evidence synthesesB. Explore how engagement in evidence synthesis promotes health equityC. Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement in evidence synthesesMethodsOur diverse, international team will develop guidance for engagement with collaborators and partners throughout multiple sequential steps using an integrated knowledge translation approach:1. Reviews. We will co-produce 1 scoping review, 3 systematic reviews and 1 evidence map focusing on (a) methods, (b) barriers and facilitators, (c) conflict of interest considerations, (d) impacts, and (e) equity considerations of engagement in evidence synthesis.2. Methods study, interviews, and survey. We will contextualise the findings of step 1 by assessing a sample of evidence syntheses reporting on engagement with collaborators and partners and through conducting interviews with collaborators and partners who have been involved in producing evidence syntheses. We will use these findings to develop draft guidance checklists and will assess agreement with each item through an international survey.3. Consensus. The guidance checklists will be co-produced and finalised at a consensus meeting with collaborators and partners.4. Dissemination. We will develop a dissemination plan with our collaborators and partners and work collaboratively to improve adoption of our guidance by key organizations.ConclusionOur international team will develop guidance for collaborator and partner engagement in health care evidence syntheses. Incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
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    Setting priorities for knowledge translation of Cochrane reviews for health equity: evidence for equity
    (2017) Tugwell, Peter; Petkovic, Jennifer; Welch, Vivian; Vincent, Jennifer; Bhutta, Zulfiqar A.; Churchill, Rachel; De Savigny, Don; Mbuagbaw, Lawrence; Pantoja Calderón, Tomás
    Abstract Background 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. Methods 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. Results 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 . Conclusions 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.
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    Use of telephone care in a cardiovascular disease management programme for type 2 diabetes patients in Santiago, Chile
    (2006) Piette, John D.; Lange Haensgen, Ilta Anita H.; Issel, Michelle; Campos Romero, Solange; Bustamante Troncoso, Claudia Raquel; Sapag Muñoz de la Peña, Jaime; Poblete A., Fernando; Tugwell, Peter; O'Connor, Annette M.
    Objectives: In 2004, the Chilean National Ministry of Health instituted a cardiovascular disease (CVD) management programme aimed at improving diabetes care among patients treated in the public healthcare system. We sought to identify the characteristics of patients participating in the CVD programme and the feasibility of extending its reach through structured nurse telephone contacts between outpatient encounters. Methods: We surveyed 569 low-income adults with type 2 diabetes treated in public clinics of Santiago, to assess patients’ participation in the CVD programme and willingness to use telephone care services. Surveys were linked to information from medical records. Results: One-third of patients met the target of two visits to the CVD programme in the previous 6 months, and an additional 32% made more than three visits. Use of the CVD programme was associated with greater patient satisfaction, even after controlling for potential confounders. However, 27% of patients had inadequate programme contact, and many of these patients were in poor health. Many CVD programme participants reported difficulties with lifestyle changes, and greater contact with the CVD programme was not associated with healthier behaviours. Most patients (95%) reported telephone access and 37% had used the telephone to contact their clinic. The majority of patients would be willing to use telephone care for additional behaviour change and emotional support. Patients with fewer CVD programme visits were particularly likely to report willingness to use telephone care. Discussion: Clinic-based CVD disease management services reach a large number of socio-economically vulnerable Chileans with diabetes. However, barriers to access remain, and planned telephone care services may increase the reach of self-management support.