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Background: Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice. Methods: A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health. Multiple databases were searched from January 2013 to May 2016. Studies were included if they were systematic reviews assessing the effectiveness of an intervention and included data on SES. Two reviewers independently screened all studies, undertook quality assessment and extracted data. A narrative approach to synthesis was adopted. Results: A total of 37 systematic reviews were included, 10 of which were explicit in the use of terminology for 'programme theory'. Twenty-nine studies used programme theory to inform both their a priori assumptions and explain their review findings. Of these, 22 incorporated considerations of both what and how interventions do/do not work in SES groups to both predict and explain their review findings. Thirteen studies acknowledged 24 unique theoretical references to support their assumptions of what or how interventions may have different effects in SES groups. Most reviewers used supplementary evidence to support their considerations of differential effectiveness. The majority of authors outlined a programme theory in the "Introduction" and "Discussion" sections of the review to inform their assumptions or provide explanations of what or how interventions may result in differential effects within or across SES groups. About a third of reviews used programme theory to inform the review analysis and/or synthesis. Few authors used programme theory to inform their inclusion criteria, data extraction or quality assessment. Twenty-one studies tested their a priori programme theory. Conclusions: The use of programme theory to inform considerations of if, what and how interventions lead to differential effects on health in different SES groups in the systematic review process is not yet widely adopted, is used implicitly, is often fragmented and is not implemented in a systematic way. [ABSTRACT FROM AUTHOR]

Background: Numerous studies examine simulation modelling in healthcare. These studies present a bewildering array of simulation techniques and applications, making it challenging to characterise the literature.Objective: The aim of this paper is to provide an overview of the level of activity of simulation modelling in healthcare and the key themes.Methods: We performed an umbrella review of systematic literature reviews of simulation modelling in healthcare. Searches were conducted of academic databases (JSTOR, Scopus, PubMed, IEEE, SAGE, ACM, Wiley Online Library, ScienceDirect) and grey literature sources, enhanced by citation searches. The articles were included if they performed a systematic review of simulation modelling techniques in healthcare. After quality assessment of all included articles, data were extracted on numbers of studies included in each review, types of applications, techniques used for simulation modelling, data sources and simulation software.Results: The search strategy yielded a total of 117 potential articles. Following sifting, 37 heterogeneous reviews were included. Most reviews achieved moderate quality rating on a modified AMSTAR (A Measurement Tool used to Assess systematic Reviews) checklist. All the review articles described the types of applications used for simulation modelling; 15 reviews described techniques used for simulation modelling; three reviews described data sources used for simulation modelling; and six reviews described software used for simulation modelling. The remaining reviews either did not report or did not provide enough detail for the data to be extracted.Conclusion: Simulation modelling techniques have been used for a wide range of applications in healthcare, with a variety of software tools and data sources. The number of reviews published in recent years suggest an increased interest in simulation modelling in healthcare. [ABSTRACT FROM AUTHOR]

Background: Qualitative research findings are increasingly used to inform decision-making. Research has indicated that not all quantitative research on the effects of interventions is disseminated or published. The extent to which qualitative researchers also systematically underreport or fail to publish certain types of research findings, and the impact this may have, has received little attention. Methods: A survey was delivered online to gather data regarding non-dissemination and dissemination bias in qualitative research. We invited relevant stakeholders through our professional networks, authors of qualitative research identified through a systematic literature search, and further via snowball sampling. Results: 1032 people took part in the survey of whom 859 participants identified as researchers, 133 as editors and 682 as peer reviewers. 68.1% of the researchers said that they had conducted at least one qualitative study that they had not published in a peer-reviewed journal. The main reasons for non-dissemination were that a publication was still intended (35.7%), resource constraints (35.4%), and that the authors gave up after the paper was rejected by one or more journals (32.5%). A majority of the editors and peer reviewers “(strongly) agreed” that the main reasons for rejecting a manuscript of a qualitative study were inadequate study quality (59.5%; 68.5%) and inadequate reporting quality (59.1%; 57.5%). Of 800 respondents, 83.1% “(strongly) agreed” that non-dissemination and possible resulting dissemination bias might undermine the willingness of funders to support qualitative research. 72.6% and 71.2%, respectively, “(strongly) agreed” that non-dissemination might lead to inappropriate health policy and health care. Conclusions: The proportion of non-dissemination in qualitative research is substantial. Researchers, editors and peer reviewers play an important role in this. Non-dissemination and resulting dissemination bias may impact on health care research, practice and policy. More detailed investigations on patterns and causes of the non-dissemination of qualitative research are needed. [ABSTRACT FROM AUTHOR]

Over twenty years evidence based practice has become established as a dominant frame of evaluation within health services management and public health. Its influence extends to all aspects of information and communication. Evidence Based Health Information (EBHI) seeks to get the best available evidence used by patients, clinicians, managers and policy makers and to use evidence based methods to communicate them. Increasingly the public health community is shifting its collective attention to so-called complex interventions, from 'what works' to 'what works for whom under what circumstances'. The author briefly reviews the background to these developments before giving examples of the practical value of this wide lens approach. The author uses a recent case study to illustrate how health service managers and public health decision makers can benefit practically from recommendations produced as a result of using a complex interventions based approach. [ABSTRACT FROM AUTHOR]

Introduction: Continuing professional development and education is vital to the provision of better health services and outcomes. The aim of this study is to contribute to the evidence base by performing a systematic review of qualitative data from studies reporting health professionals' experience of e-learning. No such previous review has been published. Method: A systematic review of qualitative data reporting UK health professionals' experiences of the ways in which on-line learning is delivered by higher education and other relevant institutions. Evidence synthesis was performed with the use of thematic analysis grounded in the data. Results: Literature searches identified 19 relevant studies. The subjects of the studies were nurses, midwives, and allied professions (8 studies), general practitioners and hospital doctors (6 studies), and a range of different health practitioners (5 studies). The majority of courses were stand-alone continuing professional development modules. Five key themes emerged from the data: peer communication, flexibility, support, knowledge validation, and course presentation and design. Discussion: The effectiveness of on-line learning is mediated by the learning experience. If they are to enhance health professionals' experience of e-learning, courses need to address presentation and course design; they must be flexible, offer mechanisms for both support and rapid assessment, and develop effective and efficient means of communication, especially among the students themselves. [ABSTRACT FROM AUTHOR]

Objectives -- The purpose of this research project was to gain insight into the information behaviour of healthcare services managers as they use information while engaged in decision-making unrelated to individual patient care. Methods -- This small-scale, exploratory, multiple case study used the critical incident technique in nineteen semi-structured interviews. Responses were analyzed using 'Framework,' a matrix-based content analysis system. Results -- This paper presents findings related to the internal information that healthcare services managers need and use. Their decisions are influenced by a wide variety of factors. They must often make decisions without all of the information they would prefer to have. Internal information and practical experience set the context for new research-based information, so they are generally considered first. Conclusions -- Healthcare services managers support decisions with both facts and value-based information. These results may inform both delivery of health library services delivery and strategic health information management planning. They may also support librarians who extend their skills beyond managing library collections and teaching published information retrieval skills, to managing internal and external information, teaching information literacy, and supporting information sharing. [ABSTRACT FROM AUTHOR]

Background: Implementation fidelity refers to the degree to which an intervention or programme is delivered as intended. Only by understanding and measuring whether an intervention has been implemented with fidelity can researchers and practitioners gain a better understanding of how and why an intervention works, and the extent to which outcomes can be improved. Discussion: The authors undertook a critical review of existing conceptualisations of implementation fidelity and developed a new conceptual framework for understanding and measuring the process. The resulting theoretical framework requires testing by empirical research. Summary: Implementation fidelity is an important source of variation affecting the credibility and utility of research. The conceptual framework presented here offers a means for measuring this variable and understanding its place in the process of intervention implementation. [ABSTRACT FROM AUTHOR]

The article examines how a group of staff from the Central Coast Health Library Services in Australia followed the five steps of evidence-based library and information practice (EBLIP) within a typical area of library activity. First, they recognize the need to develop a climate for EBLIP. EBLIP involves the integration of evidence from research studies with reports from library users and the observations of library staff. Evaluation of the rigor and relevance of the evidence, typically employing checklists as tools for a consistent approach across studies, is also applied in the process.

The article reviews what research tells about clinical questions and the questioning behavior of clinicians. Clinicians are more likely to use online information retrieval systems on days with higher numbers of patient admissions. Clinician questions clearly relate to patient care. Having recognized an information need and that an answer probably exists, the clinician has to decide whether to pursue it. The three most important words in a clinician’s vocabulary are ‘I don't know’. The admission of ignorance by a clinician to a third party, be it colleague, pharmacist, or librarian, is central to information seeking. A final category is whether an answer actually exists.

To develop and evaluate a programme of information skills training for social-care practitioners and health-care librarians.Two one-day training courses run separately for 13 social-care practitioners and 10 health-care librarians in the Trent geographic region within Northern England.Qualitative and quantitative feedback collected through questionnaires supplemented by participant observation.While generally feedback was favourable, the courses were overly ambitious. More training sessions of shorter duration would offer participants opportunities to practise and use the skills they have acquired. Social-care practitioners responded more positively to skills associated with appraising qualitative research than with randomised controlled trials. Librarians appreciated the opportunity to learn about unfamiliar social-care resources. Both practitioners and health-care librarians reported that they acquired skills to support evidence-based social care as a result of the training intervention.Involvement of a multi-disciplinary team and support from a social-care information provider maximized the impact of this experimental training intervention. [ABSTRACT FROM AUTHOR]

As a relatively recent paradigm, evidence-based information practice requires development at all stages of its cycle. Work to date has targeted such aspects as the questions practitioners consider important, the characteristics of the published evidence base and the use of tailored appraisal checklists. Perhaps, as a consequence, the application and use of research in health information practice has received correspondingly little attention. The perceived applicability of research is very subjective, being determined by such factors as the setting and nature of the reader's current service, external environmental factors, planned future developments and whether the hosting body is a learning organization. Additional moderating variables relate to the personal characteristics of individuals themselves. Much research that appears in the health information literature, and by far the largest proportion of research published in the library and information literature in general, falls into the category of research for general enlightenment. Examples in this category from the health information literature include general health service librarians reading about methods of conducting systematic reviews or reading about clinical librarianship.

It is not uncommon for practitioners to bemoan the absence of good quality research upon which they can base their day-to-day decisions. While the stereotypical research message of systematic reviews is that more research is needed, thereby securing future researcher longevity, this can lead to a very unfair perception of the usefulness of such reviews. In a quest to unearth the evidence base for information practice, to feed into future courses, articles and columns, researchers have recently identified three review-type publications with varying degrees of systematicity, that could rightly claim a place among a busy health information practitioner's essentials. Of course all this assumes that researchers have access to a broadband Internet connection rather than the ubiquitous message in a bottle. Because of the wide-ranging coverage of these three reviews researchers will momentarily depart from their previous practice of starting with a problem-based scenario. Nevertheless they welcome follow-up correspondence from any health information professional who finds him or herself using these reviews to inform their specific library practice.

Background: Qualitative research makes an important contribution to our understanding of health and healthcare. However, qualitative evidence can be difficult to search for and identify, and the effectiveness of different types of search strategies is unknown. Methods: Three search strategies for qualitative research in the example area of support for breast-feeding were evaluated using six electronic bibliographic databases. The strategies were based on using thesaurus terms, free-text terms and broad-based terms. These strategies were combined with recognised search terms for support for breast-feeding previously used in a Cochrane review. For each strategy, we evaluated the recall (potentially relevant records found) and precision (actually relevant records found). Results: A total yield of 7420 potentially relevant records was retrieved by the three strategies combined. Of these, 262 were judged relevant. Using one strategy alone would miss relevant records. The broad-based strategy had the highest recall and the thesaurus strategy the highest precision. Precision was generally poor: 96% of records initially identified as potentially relevant were deemed irrelevant. Searching for qualitative research involves trade-offs between recall and precision. Conclusions: These findings confirm that strategies that attempt to maximise the number of potentially relevant records found are likely to result in a large number of false positives. The findings also suggest that a range of search terms is required to optimise searching for qualitative evidence. This underlines the problems of current methods for indexing qualitative research in bibliographic databases and indicates where improvements need to be made. [ABSTRACT FROM AUTHOR]

The author employs his vantage point as a contributor to Evidence-based Medicine (EBM) and Evidence-based Librarianship (EBL) in the United Kingdom to anticipate obstacles to be overcome by the emerging EBL paradigm. After reviewing and synthesizing three proto-definitions of EBL, he discusses issues around the potential domains to be populated by research findings. He then briefly considers the contribution that critical appraisal skills can make to an evidence-based profession. In concluding that “evidence-based librarianship” is a selflimiting “label,” he encourages health information professionals instead to promote the contribution of librarianship to evidence-based practice, a role for which they are uniquely qualified. [ABSTRACT FROM PUBLISHER]

Focuses on the impact of health information services and computer systems on the dissemination of public health information. Dedication of the Cochrane Collaboration organization for the systematic review of information; Inclusion of health information topics in the Cochrane Library; Collaboration of health information science.

Background: There have been calls for greater consideration of applicability and transferability in systematic reviews, to improve their usefulness in informing policy and practice. Understanding how evidence is, or is not applicable and transferable to varying local situations and contexts, is a key challenge for systematic review synthesis in healthcare. Assessing applicability and transferability in systematic reviews is reported to be difficult, particularly in reviews of complex interventions. There is a need for exploration of factors perceived to be important by policy-makers, and for further guidance on which items should be reported. In this paper we focus on the process of development of a framework that can be used by systematic reviewers to identify and report data across studies relating to applicability and transferability.Methods: The framework was developed by scrutinising existing literature on applicability and transferability, examining data during a systematic review of highly complex changes to health service delivery, and was informed by stakeholder engagement. The items of the framework were thus grounded in both data identified during a real review, and stakeholder input. The paper describes examples of data identified using the framework during a review of integrated care interventions, and outlines how it informed analysis and reporting of the review findings.Results: The Framework for Implementation Transferability Applicability Reporting (FITAR) comprises 44 items which can be used to structure analysis and reporting across studies during systematic reviews of complex interventions. The framework prompts detailed consideration of contextual data during extraction and reporting, within areas of: patient type and populations; type of organisations and systems; financial and commissioning processes; systems leadership elements; features of services; features of the workforce; and finally elements of the interventions/initiatives.Conclusions: Use of the framework during our review of complex healthcare interventions helped the review team to surface contextual data, which may not be commonly extracted, analysed and reported. Further exploration and evaluation of systems for identifying and reporting these factors during reviews is required. [ABSTRACT FROM AUTHOR]

Background: Healthcare systems around the world have been responding to the demand for better integrated models of service delivery. However, there is a need for further clarity regarding the effects of these new models of integration, and exploration regarding whether models introduced in other care systems may achieve similar outcomes in a UK national health service context.Methods: The study aimed to carry out a systematic review of the effects of integration or co-ordination between healthcare services, or between health and social care on service delivery outcomes including effectiveness, efficiency and quality of care. Electronic databases including MEDLINE; Embase; PsycINFO; CINAHL; Science and Social Science Citation Indices; and the Cochrane Library were searched for relevant literature published between 2006 to March 2017. Online sources were searched for UK grey literature, and citation searching, and manual reference list screening were also carried out. Quantitative primary studies and systematic reviews, reporting actual or perceived effects on service delivery following the introduction of models of integration or co-ordination, in healthcare or health and social care settings in developed countries were eligible for inclusion. Strength of evidence for each outcome reported was analysed and synthesised using a four point comparative rating system of stronger, weaker, inconsistent or limited evidence.Results: One hundred sixty seven studies were eligible for inclusion. Analysis indicated evidence of perceived improved quality of care, evidence of increased patient satisfaction, and evidence of improved access to care. Evidence was rated as either inconsistent or limited regarding all other outcomes reported, including system-wide impacts on primary care, secondary care, and health care costs. There were limited differences between outcomes reported by UK and international studies, and overall the literature had a limited consideration of effects on service users.Conclusions: Models of integrated care may enhance patient satisfaction, increase perceived quality of care, and enable access to services, although the evidence for other outcomes including service costs remains unclear. Indications of improved access may have important implications for services struggling to cope with increasing demand.Trial Registration: Prospero registration number: 42016037725 . [ABSTRACT FROM AUTHOR]