Tailoring the presentation of systematic reviews to meet decision makers’ needshospital setting

TOHTAP

• The Ottawa Hospital Technology Assessment Program

• TOHTAP is a knowledge support service for TOH Senior Management, and other TOH stakeholders to support cost-effective decision-making

• It is a collaboration between TOH and OHRI maximizing skill sets across both institutions

• It uses systematic review methods to aggregate information about benefits, harms, and health economics

• Pilot program

Produce

• Rapid reviews• accelerated systematic reviews

• Content• search, critically appraise, and aggregate

• Output• report• must meet the needs of decision maker(s) (requester)• developed in partnership with decision maker(s)

Review outputs

• Cochrane reviews• Evidence reports

• Systematic review publications

• TOHTAP reports• time to read• broad reading audience• policy ‘thoughts’

Report production

Informative sidebar outlines the intended audience and explains the

nature of included content

Primary research question as the title

“Key messages” section aims to summarize overall findings

Intended to capture the attention of the end user as it may be all they read

Table of contents indicated each sub-section pertaining to the question

Brief background information on the subject matter is presented

Systematic review evidence is highlighted per question (includes

AMSTAR rating)

“Bottom line” subsections aim to summarize the evidence under each

sub-section

Brief summary of

the methods used:

searches; sources;

eligibility criteria;

screening/

extraction methods;

study types included;

reference to ROB

Reference to AMSTAR tool

Authors

Conflicts of interest

Acknowledgements

THANK YOU!

What is Quality of Evidence?• Much more than risk of bias

• Reviewers’ confidence in how close the observed estimate of effect is to the true effect

• Categories:

High (confident its close)

Moderate (likely to be close, but could be substantially different)

Low (may or may not be substantially different) and

Very Low (likely to be substantially different)

• Evaluated by comparison and by outcomes – patient important, up to seven, both benefit and harm, critical and important (9 point scale).

• Quality of evidence for an outcome versus the overall quality of evidence