1. Is performing a scoping review useful after recent Cochrane review?
TDH Smith1 A Akpan2 CE Lightbody3 M Gordon1 A Clegg3 C Watkins3 U Chauhan School of Medicine, UCLan, 2Aintree University Hospital, 3Faculty of Health and Wellbeing, UCLan
CHIME
(Community Holistic Interventions for Multi-morbidity in older people: Evaluation of evidence)
Reference lists:
Cochrane2 97
Academy of Medical Sciences3 (ongoing trials) 19
Database searches 19/7/18:
Medline 1335
EMBASE 107
Trial registers 27
Assessed for eligibility:
128 full-text articles
45 protocols
Included in synthesis:
5 completed studies (from 5 papers)
3 ongoing studies
5 secondary studies or duplicates
Excluded with reasons: 118 full-text articles 42 protocols
1412 records excluded based on title/abstract
Journal hand searches:
Ann Fam Med 0
BJGP BMJ JAMA 0
1585 records screened
Background
Purposes of scoping reviews1
To map extent, range and nature of research activity
To check whether full systematic review worthwhile
Summarise and demonstrate research findings to stakeholders
Identify gaps in literature where more research needed
Aims of CHIME
Disseminate research findings to Liverpool CCG to aid local decision making
Identify research gaps leading to NIHR Research for Patient Benefit (RfPB) funding bid
} aiming for systematic review
} facilitate other activities
Methods
Scoping methodology1
Aim of Poster
To compare number, nature and reliability of evidence found using scoping search for CHIME, with those that could be obtained by using Cochrane review alone.
Form research question
Identify search strategy
Select relevant studies
Chart data
Collate, summarise and report
CHIME research question
What is currently known from research about the effectiveness of community holistic interventions for older people with multimorbidity, what research is currently in progress, and what gaps in knowledge still exist?
Differences in search approaches
Difference
CHIME search
Cochrane search2
Gain/loss
Search dates
Included trials published since last Cochrane search
Only included trials published up to 28 September 2015 +3
Community definition
Occur in: primary care/minor injuries, patient’s usual residence, healthcare settings manned mainly or wholly by community-based practitioners
Delivered by primary care professionals (i.e. treat all common conditions at all ages, ongoing relationship) +1
Holistic
Addresses needs from at least 2 aspects of health: physical, mental, social, cultural
Target at least 2 different health conditions -4
Multimorbidity
2 or more concordant or discordant physical/ mental illnesses
2 or more chronic conditions -1
Elderly
Population/subgroup aged at least 60
Any age included
-12
Completed studies 5 18
-13
Ongoing
3 (screened)
19 (not screened)
-16
Results
5 published studies relevant to our population (i) being elderly (ii) having multimorbidity, and with an intervention that was (i) holistic in nature (ii) used in community setting
3 of these published since Cochrane review
Only 1 of these newly published trials was listed as ongoing in Cochrane review
3 additional ongoing trials found likely to be relevant once complete
Primary intervention method of the studies included in our review compared to Cochrane
Conclusion
Advantages of scoping review
1. Outperforms using old review in finding completed studies:
Looking at included studies in Cochrane – 1 study
Revisiting excluded studies too – 2 studies
Adding ongoing studies – 3 studies
Performing scoping review – 5 studies
2. Reviewing relevant ongoing studies better identifies gaps for future research
Topic areas which no study used/using as primary intervention:
Relevant Cochrane studies – 4 topic areas
Adding completed studies from own search – 4 topic areas
Adding ongoing studies – 3 topic areas
Advantage of using Cochrane review
Grades quality of evidence (for included studies only)
Summary
Performing a scoping review is worthwhile to identify needs for future research. However, there needs to be awareness that some included studies may be better quality than others.
References
1. Arksey H, O'Malley L. Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory & Practice 2005;8(1):19-32.
2. Smith SM, Wallace E, O’Dowd T, Fortin M. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database of Systematic Reviews 2016;CD006560(3)
3. Academy of Medical Sciences, The. Multimorbidity: a priority for global health research. April 2018