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Effective Health Care Program

Framework for Determining Research Gaps During Systematic Review: Evaluation

Research Report

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Structured Abstract

Background

Research gaps prevent systematic reviewers from making conclusions and, ultimately, limit our ability to make informed health care decisions. While there are well-defined methods for conducting a systematic review, there has been no explicit process for the identification of research gaps from systematic reviews. In a prior project we developed a framework to facilitate the systematic identification and characterization of research gaps from systematic reviews. This framework uses elements of PICOS (Population, Intervention, Comparison, Outcomes, Setting) to describe the gaps and categorizes the reasons for the gaps as (A) insufficient or imprecise information, (B) biased information, (C) inconsistent or unknown consistency results, and/or (D) not the right information.

Objective

To further develop and evaluate a framework for the identification and characterization of research gaps from systematic reviews.

Methods

We conducted two types of evaluation: (1) We applied the framework to existing systematic reviews, and (2) Evidence-based Practice Centers (EPCs) applied the framework either during a systematic review or during a future research needs project (FRN). EPCs provided feedback on the framework using an evaluation form.

Results

Our application of the framework to 50 systematic reviews identified about 600 unique research gaps. Key issues emerging from this evaluation included the need to clarify instructions for dealing with multiple comparisons (lumping vs. splitting) and need for guidance on applying the framework retrospectively. We received evaluation forms from seven EPCs. EPCs applied the framework in 8 projects, five of which were FRNs. Challenges identified by the EPCs led to revisions in the instructions including guidance for teams to decide a priori whether to limit the use of the framework to questions for which strength of evidence has been assessed, and the level of detail needed for the characterization of the gaps.

Conclusions

Our team evaluated a revised framework, and developed guidance for its application. A final version is provided that incorporates revisions based on use of the framework across existing systematic reviews and feedback from other EPCs on their use of the framework. Future research is needed to evaluate the relative costs and benefits of using the framework, for review authors and for users of the systematic reviews.