Methodological guidance for incorporating equity when informing rapid-policy and guideline development

Omar Dewidar; Brenda Allen Kawala; Alba Antequera; Andrea C Tricco; David Tovey; Sharon Straus; Rebecca Glover; Janice Tufte; Olivia Magwood; Maureen Smith; Cheow Peng Ooi; Anna Dion; Mireille Goetghebeur; Ludovic Reveiz; Stefano Negrini; Peter Tugwell; Jennifer Petkovic; Vivian Welch; COVID-END Equity Task Force

doi:10.1016/j.jclinepi.2022.07.007

Methodological guidance for incorporating equity when informing rapid-policy and guideline development

J Clin Epidemiol. 2022 Oct:150:142-153. doi: 10.1016/j.jclinepi.2022.07.007. Epub 2022 Jul 19.

Authors

Omar Dewidar¹, Brenda Allen Kawala², Alba Antequera³, Andrea C Tricco⁴, David Tovey⁵, Sharon Straus⁶, Rebecca Glover⁷, Janice Tufte⁸, Olivia Magwood⁹, Maureen Smith¹⁰, Cheow Peng Ooi¹¹, Anna Dion¹², Mireille Goetghebeur¹³, Ludovic Reveiz¹⁴, Stefano Negrini¹⁵, Peter Tugwell¹⁶, Jennifer Petkovic¹⁷, Vivian Welch¹⁸; COVID-END Equity Task Force

Affiliations

¹ Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada. Electronic address: [email protected].
² Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine-Master in Global Health, The Sahlgrenska Academy at University of Gothenburg, Box 414, SE-405 Gothenburg, Sweden.
³ Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
⁴ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, Ontario M5B 1T8, Canada; Epidemiology Division, Dalla Lana School of Public Health & Institute of Health, Management, and Policy Evaluation, University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada; Queen's Collaboration for Health Care Quality, Joanna Briggs Institute Centre of Excellence, Queen's University, 92 Barrie Street, Room 214, Kingston, Ontario K7L 3N6, Canada.
⁵ Cochrane France, Paris, France.
⁶ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, Ontario M5B 1T8, Canada.
⁷ Department of Health Services Research and Policy, Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
⁸ Hassanah Consulting, Seattle, WA 98122, USA.
⁹ Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Thompson Hall, 25 University Private, Ottawa, ON, Canada K1N 7K4.
¹⁰ Cochrane Consumer Executive, Ottawa, Ontario, Canada.
¹¹ Endocrine Unit, Department of Medicine, Universiti Putra Malaysia Faculty of Medicine and Health Sciences, 43400 Serdang, Selangor, Malaysia.
¹² Centre for Implementation Research, Ottawa Hospital Research Institute, The Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
¹³ Unit Methods, Ethics and Participation, INESSS, National Institute for Excellence in Health and Social Services, Montréal, Québec, Canada.
¹⁴ Evidence and Intelligence for Action in Health Department, Incident Management System for the Covid-19 Response. Pan American Health Organization, 525 23rd St, Northwest, WA 20037-2895, USA.
¹⁵ Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
¹⁶ Department of Medicine, and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Ontario, Canada.
¹⁷ Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Ontario, Canada.
¹⁸ Bruyère Research Institute, University of Ottawa, 85 Primrose Ave, Ottawa, Ontario K1R 6M1, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada.

Abstract

Objectives: We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews.

Study design and setting: This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for equity-focused systematic reviews (PRISMA-Equity) guideline. We identified Exemplar rapid reviews by searching COVID-19 databases and requesting examples from our team.

Results: We proposed the following key steps: 1. involve relevant stakeholders with lived experience in the conduct and design of the review; 2. reflect on equity, inclusion and privilege in team values and composition; 3. develop research question to assess health inequities; 4. conduct searches in relevant disciplinary databases; 5. collect data and critically appraise recruitment, retention and attrition for populations experiencing inequities; 6. analyse evidence on equity; 7. evaluate the applicability of findings to populations experiencing inequities; and 8. adhere to reporting guidelines for communicating review findings. We illustrated these methods through rapid review examples.

Conclusion: Implementing this guidance could contribute to improving equity considerations in rapid reviews produced in public health emergencies, and help policymakers better understand the distributional impact of diseases on the population.

Keywords: Equity; Guidance; Guideline development; Policy; Rapid reviews; Stakeholder engagement.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Databases, Factual
Health Equity*
Humans
Policy
Public Health

Grants and funding

Department of Health/United Kingdom