Vivian Welch and colleagues present consensus-based guidelines for reporting equity-focused systematic reviews, the PRISMA-Equity extension.

/pdf/prisma-equity-2012-extension-reporting-guidelines-for-50dje4sr1t.pdf

PRISMA-Equity 2012 Extension: Reporting Guidelines for Systematic Reviews with a Focus on Health Equity

CITATION: Usenbo, A., et al. 2015. Prevalence of arthritis in Africa : a systematic review and meta-analysis. PLoS ONE, 10(8):1-19, doi:10.1371/journal.pone.0133858.

/pdf/prevalence-of-arthritis-in-africa-a-systematic-review-and-46z9wfvv3x.pdf

Prevalence of Arthritis in Africa: A Systematic Review and Meta-Analysis.

Background
Enhancing health equity has now achieved international political importance with endorsement from the World Health Assembly in 2009.  The failure of systematic reviews to consider effects on health equity is cited by decision-makers as a limitation to their ability to inform policy and program decisions. 

Objectives
To systematically review methods to assess effects on health equity in systematic reviews of effectiveness.

Search methods
We searched the following databases up to July 2 2010: MEDLINE, PsychINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Index to Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on October 7 2010.

Selection criteria
We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities.

Data collection and analysis
Data were extracted using a pre-tested form by two independent reviewers. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews. 

Main results
Thirty-four methodological studies were included.  The methods used by these included studies were: 1) Targeted approaches (n=22); 2) gap approaches (n=12) and gradient approach (n=1).  Gender or sex was assessed in eight out of 34 studies, socioeconomic status in ten studies, race/ethnicity in seven studies, age in seven studies, low and middle income countries in 14 studies, and two studies assessed multiple factors across health inequity may exist.

Only three studies provided a definition of health equity. Four methodological approaches to assessing effects on health equity were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (all 34 studies used a type of descriptive method); 2) descriptive assessment of reporting and analysis in original trials (12/34 studies); 3) analytic approaches (10/34 studies); and 4) applicability assessment (11/34 studies). Both analytic and applicability approaches were not reported transparently nor in sufficient detail to judge their credibility.

Authors' conclusions
There is a need for improvement in conceptual clarity about the definition of health equity, describing sufficient detail about analytic approaches (including subgroup analyses) and transparent reporting of judgments required for applicability assessments in order to assess and report effects on health equity in systematic reviews.

How effects on health equity are assessed in systematic reviews of interventions

At the Rio Summit in 2011 on Social Determinants of Health, the global community recognized a pressing need to take action on reducing health inequities This requires an improved evidence base on the effects of national and international policies on health inequities Although systematic reviews are recognized as an important source for evidence-informed policy, they have been criticized for failing to assess effects on health equity This article summarizes guidance on both conducting systematic reviews with a focus on health equity and on methods to translate their findings to different audiences This guidance was developed based on a series of methodology meetings, previous guidance, a recently developed reporting guideline for equity-focused systematic reviews (PRISMA-Equity 2012) and a systematic review of methods to assess health equity in systematic reviews We make ten recommendations for conducting equity-focused systematic reviews; and five considerations for knowledge translation Illustrative examples of equity-focused reviews are provided where these methods have been used Implementation of the recommendations in this article is one step toward monitoring the impact of national and international policies and programs on health equity, as recommended by the 2011 World Conference on Social Determinants of Health

https://www.ruor.uottawa.ca/bitstream/10393/34004/1/13643_2013_Article_109.pdf

Health equity: evidence synthesis and knowledge translation methods

The need for research-based knowledge to inform health policy formulation and implementation is a chronic global concern impacting health systems functioning and impeding the provision of quality healthcare for all. This paper provides a systematic overview of the literature on knowledge translation (KT) strategies employed by health system researchers and policy-makers in African countries. Evidence mapping methodology was adapted from the social and health sciences literature and used to generate a schema of KT strategies, outcomes, facilitators and barriers. Four reference databases were searched using defined criteria. Studies were screened and a searchable database containing 62 eligible studies was compiled using Microsoft Access. Frequency and thematic analysis were used to report study characteristics and to establish the final evidence map. Focus was placed on KT in policy formulation processes in order to better manage the diversity of available literature. The KT literature in African countries is widely distributed, problematically diverse and growing. Significant disparities exist between reports on KT in different countries, and there are many settings without published evidence of local KT characteristics. Commonly reported KT strategies include policy briefs, capacity-building workshops and policy dialogues. Barriers affecting researchers and policy-makers include insufficient skills and capacity to conduct KT activities, time constraints and a lack of resources. Availability of quality locally relevant research was the most reported facilitator. Limited KT outcomes reflect persisting difficulties in outcome identification and reporting. This study has identified substantial geographical gaps in knowledge and evidenced the need to boost local research capacities on KT practices in low- and middle-income countries. Evidence mapping is also shown to be a useful approach that can assist local decision-making to enhance KT in policy and practice.

/pdf/evidence-map-of-knowledge-translation-strategies-outcomes-ynb3pnz74h.pdf

Evidence map of knowledge translation strategies, outcomes, facilitators and barriers in African health systems

Background: Research on identifying trials using geographic filters is limited.

Objectives:  To test the sensitivity and precision of a filter to identify African randomised controlled trials (RCTs).

Methods:  We searched medline and embase for RCTs published in 2004 using a Cochrane filter for RCTs. The search was limited to HIV/AIDS but irrespective of location. Two investigators independently identified African RCTs from the retrieved records forming a reference set. We then repeated the search using an African geographic filter comprising country and regional terms forming the filter set. We compared the sensitivity and precision of the sets.

Results:  The medline reference set comprised 1799 records with 23 African RCTs; for embase, the reference set comprised 763 records with 37 African RCTs. The medline filter set comprised 180 records with 17 African RCTs; the embase filter set comprised 98 records with 27 African RCTs. Sensitivity of the filter was 74% (medline) and 73% (embase). Addition of the filter improved precision from 1.3% to 9.4% (medline) and from 5% to 28% (embase).

Conclusion:  The African filter improved precision with some loss in sensitivity. Incomplete reporting of trial location in electronic bibliographic records restricts efficiency of geographic filters. Prospective trial registration should alleviate this.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-1842.2011.00936.x

Developing a geographic search filter to identify randomised controlled trials in Africa: finding the optimal balance between sensitivity and precision

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Developing a geographic search filter to identify randomised controlled trials in Africa: finding the optimal balance between sensitivity and precision