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      Developing and refining the methods for a ‘one-stop shop’ for research evidence about health systems

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          Abstract

          Background

          Policymakers, stakeholders and researchers have not been able to find research evidence about health systems using an easily understood taxonomy of topics, know when they have conducted a comprehensive search of the many types of research evidence relevant to them, or rapidly identify decision-relevant information in their search results.

          Methods

          To address these gaps, we developed an approach to building a ‘one-stop shop’ for research evidence about health systems. We developed a taxonomy of health system topics and iteratively refined it by drawing on existing categorization schemes and by using it to categorize progressively larger bundles of research evidence. We identified systematic reviews, systematic review protocols, and review-derived products through searches of Medline, hand searches of several databases indexing systematic reviews, hand searches of journals, and continuous scanning of listservs and websites. We developed an approach to providing ‘added value’ to existing content (e.g., coding systematic reviews according to the countries in which included studies were conducted) and to expanding the types of evidence eligible for inclusion (e.g., economic evaluations and health system descriptions). Lastly, we developed an approach to continuously updating the online one-stop shop in seven supported languages.

          Results

          The taxonomy is organized by governance, financial, and delivery arrangements and by implementation strategies. The ‘one-stop shop’, called Health Systems Evidence, contains a comprehensive inventory of evidence briefs, overviews of systematic reviews, systematic reviews, systematic review protocols, registered systematic review titles, economic evaluations and costing studies, health reform descriptions and health system descriptions, and many types of added-value coding. It is continuously updated and new content is regularly translated into Arabic, Chinese, English, French, Portuguese, Russian, and Spanish.

          Conclusions

          Policymakers and stakeholders can now easily access and use a wide variety of types of research evidence about health systems to inform decision-making and advocacy. Researchers and research funding agencies can use Health Systems Evidence to identify gaps in the current stock of research evidence and domains that could benefit from primary research, systematic reviews, and review overviews.

          Electronic supplementary material

          The online version of this article (doi:10.1186/1478-4505-13-10) contains supplementary material, which is available to authorized users.

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          Most cited references25

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          How Can We Support the Use of Systematic Reviews in Policymaking?

          John Lavis (2009)
          John Lavis discusses how health policymakers and their stakeholders need research evidence, and the best ways evidence can be synthesized and packaged to optimize its use.
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            Effects of policy options for human resources for health: an analysis of systematic reviews.

            Policy makers face challenges to ensure an appropriate supply and distribution of trained health workers and to manage their performance in delivery of services, especially in countries with low and middle incomes. We aimed to identify all available policy options to address human resources for health in such countries, and to assess the effectiveness of these policy options. We searched Medline and Embase from 1979 to September, 2006, the Cochrane Library, and the Human Resources for Health Global Resource Center database. We also searched up to 10 years of archives from five relevant journals, and consulted experts. We included systematic reviews in English which assessed the effects of policy options that could affect the training, distribution, regulation, financing, management, organisation, or performance of health workers. Two reviewers independently assessed each review for eligibility and quality, and systematically extracted data about main effects. We also assessed whether the policy options were equitable in their effects; suitable for scaling up; and applicable to countries with low and middle incomes. 28 of the 759 systematic reviews of effects that we identified were eligible according to our criteria. Of these, only a few included studies from countries with low and middle incomes, and some reviews were of low quality. Most evidence focused on organisational mechanisms for human resources, such as substitution or shifting tasks between different types of health workers, or extension of their roles; performance-enhancing strategies such as quality improvement or continuing education strategies; promotion of teamwork; and changes to workflow. Of all policy options, the use of lay health workers had the greatest proportion of reviews in countries with a range of incomes, from high to low. We have identified a need for more systematic reviews on the effects of policy options to improve human resources for health in countries with low and middle incomes, for assessments of any interventions that policy makers introduce to plan and manage human resources for health, and for other research to aid policy makers in these countries.
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              Assessing country-level efforts to link research to action.

              We developed a framework for assessing country-level efforts to link research to action. The framework has four elements. The first element assesses the general climate (how those who fund research, universities, researchers and users of research support or place value on efforts to link research to action). The second element addresses the production of research (how priority setting ensures that users' needs are identified and how scoping reviews, systematic reviews and single studies are undertaken to address these needs). The third element addresses the mix of four clusters of activities used to link research to action. These include push efforts (how strategies are used to support action based on the messages arising from research), efforts to facilitate "user pull" (how "one-stop shopping" is provided for optimally packaged high-quality reviews either alone or as part of a national electronic library for health, how these reviews are profiled during "teachable moments" such as intense media coverage, and how rapid-response units meet users' needs for the best research), "user pull" efforts undertaken by those who use research (how users assess their capacity to use research and how structures and processes are changed to support the use of research) and exchange efforts (how meaningful partnerships between researchers and users help them to jointly ask and answer relevant questions). The fourth element addresses approaches to evaluation (how support is provided for rigorous evaluations of efforts to link research to action).
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                Author and article information

                Contributors
                lavisj@mcmaster.ca
                wilsom2@mcmaster.ca
                moatka@mcmaster.ca
                hammila@mcmaster.ca
                jennboyko@gmail.com
                jgrimshaw@ohri.ca
                signe.flottorp@kunnskapssenteret.no
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                25 February 2015
                2015
                : 13
                : 10
                Affiliations
                [ ]McMaster Health Forum, 1280 Main St. West, MML-417, Hamilton, ON L8S 4L6 Canada
                [ ]Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St. West, CRL-209, Hamilton, ON L8S 4K1 Canada
                [ ]Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main St. West, CRL-209, Hamilton, ON L8S 4 K1 Canada
                [ ]Department of Political Science, McMaster University, 1280 Main St. West, CRL-209, Hamilton, ON L8S 4 K1 Canada
                [ ]Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Cambridge, MA 02115 USA
                [ ]School of Health Studies, Western University, Arthur and Sonia Labatt Health Sciences Building, Room 403, London, ON N6A 5B9 Canada
                [ ]Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital – General Campus, 501 Smyth Rd., Box 711, Ottawa, ON K1H 8 L6 Canada
                [ ]Department of Medicine, University of Ottawa, 451 Smyth Rd., Ottawa, ON K1H 8 M5 Canada
                [ ]Norwegian Knowledge Centre for the Health Services, Boks 7004, St., Olavsplass, Oslo N-0130 Norway
                Article
                379
                10.1186/1478-4505-13-10
                4429608
                25971248
                0500831c-0590-4801-899c-48bec17d29f2
                © Lavis et al.; licensee BioMed Central. 2015

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 31 July 2014
                : 9 January 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                Health & Social care

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