Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-25T17:06:20.320Z Has data issue: false hasContentIssue false
  • English
  • Français

Identification of research gaps from evidence-based guidelines: A pilot study in cystic fibrosis

Published online by Cambridge University Press:  27 June 2011

Karen A. Robinson ,
Ian J. Saldanha  and
Naomi A. McKoy
Karen A. Robinson
Affiliation:
Johns Hopkins University
Ian J. Saldanha
Affiliation:
Johns Hopkins University
Naomi A. McKoy
Affiliation:
Johns Hopkins University
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Evidence-based guideline committees are multidisciplinary and explicitly consider the existing evidence. They are thus in an ideal position to identify research gaps. However, gaps have not been systematically identified through guidelines. We pilot tested a method to systematically identify and classify gaps from evidence-based guidelines.

Methods: We reviewed all evidence-based guidelines published by the Cystic Fibrosis Foundation. We identified research gaps as topics for which there was insufficient evidence (recommendations were not made or consensus recommendations were made) and topics specified as needing further research. We characterized gaps using a standard framework and classified them by type of management issue, specificity of target population, and age of target population.

Results: We identified sixty-two research gaps in five guidelines (mean = 12.4/guidelines document). While thirteen gaps were topics specified as needing further research, most (n = 49) were topics with insufficient evidence. Of these forty-nine, recommendations were not made for twenty-two topics while consensus recommendations were made for twenty-seven topics. Most gaps were issues of comparative effectiveness (44/62), addressed the general cystic fibrosis population (40/62), and were specific to infants (33/62). Relevant comparisons and outcomes were explicitly stated for only 7 percent and 16 percent of gaps respectively.

Conclusions: Almost 80 percent of the gaps were not topics identified as future research needs in the guidelines documents but rather were topics with insufficient evidence for making recommendations. Although we used cystic fibrosis in the United States as an example, the method we developed could be applied in other settings, including other countries and for different diseases.

Keywords

Evidence-based practiceGuidelines as topicResearch designs
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 27 , Issue 3 , July 2011 , pp. 247 - 252
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. AHRQ (Agency for Healthcare Research and Quality). Glossary of Terms. [Web Page]; http://effectivehealthcare.ahrq.gov/index.cfm/glossary-of-terms/?filterletter=c (accessed March 15, 2011).Google Scholar
2. Borowitz, D, Robinson, KA, Rosenfeld, M, et al. Cystic Fibrosis Foundation evidence-based guidelines for management of infants with cystic fibrosis. J Pediatr. 2009;155 (Suppl):S73–S93.CrossRefGoogle ScholarPubMed
3. Brown, P, Brunnhuber, K, Chalkidou, K, et al. How to formulate research recommendations. BMJ. 2006;333:804–806.CrossRefGoogle ScholarPubMed
4. Chalkidou, K, Whicher, D, Kary, W, Tunis, S. Comparative effectiveness research priorities: Identifying critical gaps in evidence for clinical and health policy decision making. Int J Technol Assess Health Care. 2009;25:241–248.CrossRefGoogle ScholarPubMed
5. Chou, R, Ballantyne, JC, Fanciullo, GJ, Fine, PG, Miaskowski, C. Research gaps on use of opioids for chronic noncancer pain: Findings from a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10:147–159.CrossRefGoogle ScholarPubMed
6. Clarke, L, Clarke, M, Clarke, T. How useful are Cochrane reviews in identifying research needs? J Health Serv Res Policy. 2007;12:101–103.CrossRefGoogle ScholarPubMed
7. de Vet, HC, Kroese, ME, Scholten, RJ, Bouter, LM. A method for research programming in the field of evidence-based medicine. Int J Technol Assess Health Care. 2001;17:433–441.CrossRefGoogle ScholarPubMed
8. Flume, PA, Mogayzel, PJJ, Robinson, KA, et al. Cystic fibrosis pulmonary guidelines: Treatment of pulmonary exacerbations. Am J Respir Crit Care Med. 2009;180:802–808.CrossRefGoogle ScholarPubMed
9. Flume, PA, O'Sullivan, BP, Robinson, KA, et al. Cystic fibrosis pulmonary guidelines: Chronic medications for maintenance of lung health. Am J Respir Crit Care Med. 2007;176:957–969.CrossRefGoogle ScholarPubMed
10. Flume, PA, Robinson, KA, O'Sullivan, BP, et al. Cystic fibrosis pulmonary guidelines: Airway clearance therapies. Respir Care. 2009;54:522–537.Google ScholarPubMed
11. IOM (Institute of Medicine). Initial national priorities for comparative effectiveness research. Washington, DC: The National Academies Press; 2009.Google Scholar
12. Johnson, NP, Proctor, M, Farquhar, CM. Gaps in the evidence for fertility treatment-an analysis of the Cochrane Menstrual Disorders and Subfertility Group database. Hum Reprod. 2003;18:947–954.Google ScholarPubMed
13. National Health Service. UK Database of Uncertainties about the Effects of Treatments (DUETs). [Web Page]; http://www.library.nhs.uk/duets/ (accessed March 15, 2011).Google Scholar
14. National Institutes of Health. NIH Budget. [Web Page]; http://www.nih.gov/about/budget.htm (Accessed March 15, 2011).Google Scholar
15. Noorani, HZ, Husereau, DR, Boudreau, R, Skidmore, B. Priority setting for health technology assessments: A systematic review of current practical approaches. Int J Technol Assess Health Care. 2007;23:310–315.CrossRefGoogle ScholarPubMed
16. Sawaya, GF, Guirguis-Blake, J, LeFevre, M, Harris, R, Petitti, D. Update on the methods of the U.S. Preventive Services Task Force: Estimating certainty and magnitude of net benefit. Ann Intern Med. 2007;147:871–875.CrossRefGoogle ScholarPubMed
17. Scott, NA, Moga, C, Harstall, C, Magnan, J. Using health technology assessment to identify research gaps: An unexploited resource for increasing the value of clinical research. Healthc Policy. 2008;3:e109–e127.Google ScholarPubMed
18. Shekelle, PG, Woolf, SH, Eccles, M, Grimshaw, J. Developing clinical guidelines. West J Med. 1999;170:348–351.Google ScholarPubMed
19. Shepherd, J, Briggs, J, Payne, L, et al. Setting the future policy agenda for health technology assessment: A specialty mapping approach. Int J Technol Assess Health Care. 2007;23:405–413.CrossRefGoogle ScholarPubMed
20. Stallings, VA, Stark, LJ, Robinson, KA, Feranchak, AP, Quinton, H. Evidence-based practice recommendations for nutrition-related management of children and adults with cystic fibrosis and pancreatic insufficiency: Results of a systematic review. J Am Diet Assoc. 2008;108:832–839.CrossRefGoogle ScholarPubMed
21. World Health Organization. WHO handbook for guideline development. March 2008. [Web Page]; http://www.searo.who.int/LinkFiles/RPC_Handbook_Guideline_Development.pdf (accessed March 15, 2011).Google Scholar
Supplementary material: File

Robinson et al. supplementary material

Supplementary table 1

Download Robinson et al. supplementary material(File)
File 34.8 KB