The Relevance of Health Equity to the Evidence Synthesis Process: Results From a Quantitative Survey of Health Information Professionals
DOI:
https://doi.org/10.18060/28655Keywords:
Evidence synthesis, Systematic reviews, Health equity, Health sciences librarians, Health information professionalsAbstract
Background
In their work as research collaborators, health information professionals often contribute both extensive knowledge of evidence synthesis methods and an engaged awareness of the sociopolitical context in which evidence synthesis takes place. Within this context, researchers are increasingly being encouraged to demonstrate how their work will advance health equity. Our study sought to determine how confident health information professionals feel discussing health equity in an evidence synthesis context and how relevant they think it is to the process.
Methods
Using the email lists of U.S.-based and international library organizations, the authors conducted a quantitative survey of health information professionals with experience working on evidence synthesis projects (e.g., systematic or scoping reviews) within the past 10 years. The authors used the survey software Qualtrics to calculate descriptive statistics for each of the survey questions and analyze correlations between responses to different questions.
Results
While a majority of health information professionals surveyed exhibited both familiarity with health equity as a concept and a belief in its relevance to evidence synthesis, far fewer were highly comfortable discussing health equity with researchers. Only 6% of participants had used the PRISMA-Equity Extension (a health equity-centered evidence synthesis tool) in a systematic review.
Discussion
The study results suggest that a number of health information professionals would benefit from training on health equity-centered evidence synthesis tools and more experience having health equity-related research discussions.
References
1. Cochrane [Internet]. London: Cochrane; 2000-2024. Evidence synthesis - what is it and why do we need it?; 2023 May 4 [cited 2024 Nov 6]. Available from: https://www.cochrane.org/news/evidence-synthesis-what-it-and-why-do-we-need-it
2. Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal. 2009 Jun;26(2):91-108.
3. Cochrane Library [Internet]. London: Cochrane; c2000-2024. About Cochrane reviews: what is a systematic review?; [cited 2024 Nov 7]. Available from: https://www.cochranelibrary.com/about/about-cochrane-reviews
4. Joanna Briggs Institute (JBI) [Internet]. Adelaide: JBI. JBI critical appraisal tools: checklist for systematic reviews and research syntheses; 2017 [cited 2024 Nov 8]; p. 2. Available from: https://jbi.global/sites/default/files/2019-05/JBI_Critical_Appraisal-Checklist_for_Systematic_Reviews2017_0.pdf
5. Eden J, Levit L, Berg A, and Morton S, editors. Finding what works in health care: standards for systematic reviews [Internet]. Washington, DC: The National Academies Press; c2011 [cited 2024 Nov 6]. Available from: https://nap.nationalacademies.org/read/13059/chapter/1
6. American Physical Therapy Association [Internet]. Alexandria: American Physical Therapy Association. Components of evidence-based practice; 2020 Mar 23 [cited 2024 Nov 6]; Available from: https://www.apta.org/patient-care/evidence-based-practice-resources/components-of-evidence-based-practice
7. Cumpston M, Flemyng E. Chapter II: Planning a Cochrane review [updated 2023 Aug]. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane handbook for systematic reviews of interventions [Internet]. version 6.5. London (UK): Cochrane; c2024 [cited 2024 Nov 7]. [about 5 screens]. Available from: https://training.cochrane.org/handbook/current/chapter-ii#section-ii-3
8. Relevo R, Balshem, H. Finding evidence for comparing medical interventions. In: Methods guide for effectiveness and comparative effectiveness reviews [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); c2008- [cited 2024 Nov 7]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53479/
9. Spencer AJ, Eldredge JD. Roles for librarians in systematic reviews: a scoping review. J Med Libr Assoc. 2018 Jan 12;106(1). https://doi.org/10.5195/jmla.2018.82
10. Petticrew M, Whitehead M, Macintyre SJ, Graham H, Egan M. Evidence for public health policy on inequalities: 1: the reality according to policymakers. J Epidemiol Community Health. 2004 Oct;58(10):811-6. https://doi.org/10.1136/jech.2003.015289
11. Welch, V., Tugwell, P., Petticrew, M., de Montigny, J., Ueffing, E., Kristjansson, B., McGowan, J., Benkhalti Jandu, M., Wells, G., Brand, K., & et al. (2010). How effects on health equity are assessed in systematic reviews of interventions. Cochrane Database of Systematic Reviews, 12. https://doi.org/10.1002/14651858.MR000028.pub2
12. Aves T, Kredo T, Welch V, Mursleen S, Ross S, Zani B, et al. Equity issues were not fully addressed in Cochrane human immunodeficiency virus systematic reviews. J Clin Epidemiol. 2017 Jan 1;81:96-100. https://doi.org/10.1016/j.jclinepi.2016.09.008
13. Evans J, Mwangi N, Burn H, Ramke J. Equity was rarely considered in Cochrane Eyes and Vision systematic reviews and primary studies on cataract. J Clin Epidemiol. 2020 Sep 1;125:57-63. https://doi.org/10.1016/j.jclinepi.2020.04.024
14. World Health Organization [Internet]. Geneva: World Health Organization; 2024. Health equity; [cited 2024 Nov 12]. Available from: https://www.who.int/health-topics/health-equity#tab=tab_1
15. Burford BJ, Welch V, Waters E, Tugwell P, Moher D, O’Neill J, Koehlmoos T, Petticrew M. Testing the PRISMA-Equity 2012 reporting guideline: the perspectives of systematic review authors. PLOS One. 2013 Oct 10;8(10):e75122.
16. Welch VA, Petticrew M, O’Neill J, Waters E, Armstrong R, Bhutta ZA, et al. Health equity: evidence synthesis and knowledge translation methods. Syst Rev. 2013 Dec;2(1):43. https://doi.org/10.1186/2046-4053-2-43
17. Parker R, Petkovic J, Pardo Pardo J, Darzi A, Dewidar O, Khabsa J, et al. The equity group: supporting Cochrane’s social responsibility of improving health equity. Cochrane Evid Synth Meth. 2023 May;1(3):e12012. https://doi.org/10.1002/cesm.12012
18. Petticrew, M, Glover RE, Volmink J, Blanchard L, Cott É, Knai C, et al. The Commercial Determinants of Health and Evidence Synthesis (CODES): methodological guidance for systematic reviews and other evidence syntheses. Syst Rev. 2023 Sep 14; 12(1):165. https://doi.org/10.1186/s13643-023-02323-0
19. Schell CL, Rathe RJ. Meta-analysis: a tool for medical and scientific discoveries. Bull Med Libr Assoc. 1992 Jul;80(3):219.
20. Mead TL, Richards DT. Librarian participation in meta-analysis projects. Bull Med Libr Assoc. 1995 Oct;83(4):461.
21. Smith Jr. JT. Meta-analysis: the librarian as a member of an interdisciplinary research team. Libr Trends. 1996;45(2):265–79.
22. MEDLINE History [Internet]. U.S. National Library of Medicine; [cited 2024 Nov 1]. Available from: https://www.nlm.nih.gov/medline/medline_history.html
23. Bastian H, Glasziou P, Chalmers I. Seventy-five trials and eleven systematic reviews a day: how will we ever keep up? PLOS Med. 2010 Sep 21;7(9):e1000326. https://doi.org/10.1371/journal.pmed.1000326
24. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions [Internet]. Vol. version 6.5 (updated August 2024). Cochrane; 2024 [cited 2024 Nov 5]. Available from: https://training.cochrane.org/handbook
25. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. JBI; 2024 [cited 2024 Nov 5]. Available from: https://jbi-global-wiki.refined.site/space/MANUAL
26. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005 Feb 1;8(1):19–32. https://doi.org/10.1080/1364557032000119616
27. Rethlefsen ML, Farrell AM, Osterhaus Trzasko LC, Brigham TJ. Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews. J Clin Epidemiol. 2015 Jun 1;68(6):617–26. https://doi.org/10.1016/j.jclinepi.2014.11.025
28. Koffel JB, Rethlefsen ML. Reproducibility of search strategies is poor in systematic reviews published in high-impact pediatrics, cardiology and surgery journals: a cross-sectional study. PLOS ONE. 2016 Sep 26;11(9):e0163309. https://doi.org/10.1371/journal.pone.0163309
29. Meert D, Torabi N, Costella J. Impact of librarians on reporting of the literature searching component of pediatric systematic reviews. J Med Libr Assoc. 2016;104(4):267–77. https://doi.org/10.3163/1536-5050.104.4.004
30. Ramirez D, Foster MJ, Kogut A, Xiao D. Adherence to systematic review standards: impact of librarian involvement in Campbell Collaboration’s education reviews. J Acad Librariansh. 2022 Sep 1;48(5):102567. https://doi.org/10.1016/j.acalib.2022.102567
31. Schellinger J, Sewell K, Bloss J, Ebron T, Forbes C. The effect of librarian involvement on the quality of systematic reviews in dental medicine. PLOS One. 2021 Sep 1;16(9). https://doi.org/10.1371/journal.pone.0256833
32. Logan J. Why do researchers co-author evidence syntheses with librarians? a mixed-methods study. Res Synth Methods [Internet]. 2023 Feb 20 [cited 2023 Mar 23]. https://doi.org/10.1002/jrsm.1629
33. Nicholson J, McCrillis A, Williams JD. Collaboration challenges in systematic reviews: a survey of health sciences librarians. J Med Libr Assoc. 2017 Oct 2;105(4):385–93. https://doi.org/10.5195/jmla.2017.176
34. Ross-White A. Search is a verb: systematic review searching as invisible labor. J Med Libr Assoc. 2021 Oct 5;109(3):505–9. https://doi.org/10.5195/jmla.2021.1226
35. Bloss J, Sewell K, Schellinger J, Haberstroh A. Health sciences and medical librarians conducting research and their experiences asking for co-authorship. J Med Libr Assoc. 2022 Oct;110(4):449–62. https://doi.org/10.5195/jmla.2022.1485
36. Brunskill A, Hanneke R. The case of the disappearing librarians: analyzing documentation of librarians’ contributions to systematic reviews. J Med Libr Assoc. 2022 Oct;110(4):409–18. https://doi.org/10.5195/jmla.2022.1505
37. Demetres M, Wright D, Hickner A, Jedlicka C, Delgado D. A decade of systematic reviews: an assessment of Weill Cornell Medicine’s systematic review service. J Med Libr Assoc. 2023 Jul;111(3):728–32.12. https://doi.org/10.5195/jmla.2023.1628
38. Kallaher A, Eldermire E, Fournier C, Ghezzi-Kopel K, Johnson K, Morris-Knower J, et al. Library systematic review service supports evidence-based practice outside of medicine. J Acad Librariansh. 2020 Nov;46(6). https://doi.org/10.1016/j.acalib.2020.102222
39. Luca E, Ulyannikova Y. Towards a user-centred systematic review service: the transformative power of service design thinking. J Aust Libr Inf Assoc. 2020;69(3):357–74. https://doi.org/10.1080/24750158.2020.1760506
40. McKeown S, Ross-White A. Building capacity for librarian support and addressing collaboration challenges by formalizing library systematic review services. J Med Libr Assoc. 2019 Jul;107(3):411–9. https://doi.org/10.5195/jmla.2019.443
41. Roth S. Transforming the systematic review service: a team-based model to support the educational needs of researchers. J Med Libr Assoc. 2018 Oct;106(4):514–20. https://doi.org/10.5195/jmla.2018.430
42. Yang L, Orchanian-Cheff A, Anderson M, Farrell A, Tripp T. Implementing a three-tiered service model for knowledge syntheses at an academic teaching hospital. J Can Health Libr Assoc. 2020 Aug;41(2):46–66. https://doi.org/10.29173/jchla29436
43. Waters E, Armstrong R. Knowledge synthesis, translation and exchange in public health and promotion: the role of a Cochrane Review Group. Prompt Educ. 2007; 14(1): 34-35.
44. Evans T, Brown H. Road traffic crashes: operationalizing equity in the context of health sector reform. Inj Control Saf Promot. 2003 Mar-Jun;10(1-2):11-2. https://doi.org/10.1076/icsp.10.1.11.14117
45. Karran EL, Cashin AG, Barker T, Boyd MA, Chiarotto A, Dewidar O, et al. Using PROGRESS-plus to identify current approaches to the collection and reporting of equity-relevant data: a scoping review. J Clin Epidemiol. 2023 Nov;163:70-78. https://doi.org/10.1016/j.jclinepi.2023.09.017
46. Kavanagh J, Oliver S, and Lorenc T. Reflections on developing and using PROGRESS-Plus. Equity update [Internet]. 2008 Mar 3 [cited 2014 Nov 7]; 2(1): 1,3. Available from: http://methods.cochrane.org/sites/methods.cochrane.org.equity/files/uploads/Equity_Update_Vol2_Issue1.pdf
47. Welch VA, Petkovic J, Jull J, Hartling L, Klassen T, Kristjansson E, et al. Chapter 16: Equity and specific populations [updated October 2019]. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane handbook for systematic reviews of interventions [Internet]. version 6.5. London (UK): Cochrane; c2024 [cited 2024 Nov 7]. Available from: https://training.cochrane.org/handbook/current/chapter-16
48. Madani MT, Madani L, Ghogomu ET, Dahrouge S, Hébert PC, Juando-Prats C, Mulligan K, Welch V. Is equity considered in systematic reviews of interventions for mitigating social isolation and loneliness in older adults? BMC Public Health. 2022 Dec 1;22(1):2241. https://doi.org/10.1186/s12889-022-14667-8
49. Hartwell M, Lin V, Gatewood A, Sajjadi NB, Garrett M, Reddy AK, et al. Health disparities, COVID-19, and maternal and childbirth outcomes: a meta-epidemiological study of equity reporting in systematic reviews. J Matern Fetal Neonatal Med. 2022 Dec
12;35(25):9622-30. https://doi.org/10.1080/14767058.2022.2049750
50. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization; 2008. 247 p.
51. Tugwell P, Petticrew M, Kristjansson E, Welch V, Ueffing E, Waters E, et al. Assessing equity in systematic reviews: realising the recommendations of the Commission on Social Determinants of Health. BMJ. 2010 Sep 13;341:c4739. https://doi.org/10.1136/bmj.c4739
52. Rio political declaration on social determinants of health [Internet]. World Health Organization. Geneva: World Health Organization; 2011 Oct 19-21 [cited 2024 Nov 13]. 7 p. Available from: https://www.who.int/publications/m/item/rio-political-declaration-on-socialdeterminants-of-health
53. Welch V, Petticrew M, Tugwell P, Moher D, O’Neill J, Waters E, et al. PRISMA-Equity 2012 extension: reporting guidelines for systematic reviews with a focus on health equity. PLOS Med. 2012 Oct 30; 9(10): e1001333. https://doi.org/10.1371/journal.pmed.1001333
54. Welch V, Petticrew M, Petkovic J, Moher D, Waters E, White H, et al. Extending the PRISMA statement to equity-focused systematic reviews (PRISMA-E 2012): explanation and elaboration. Int J Equity Health. 2015 Oct 8;14:92. https://doi.org/10.1186/s12939-015-0219-2
55. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. Adelaide: JBI; c2024. Chapter 2.1, Equity, diversity, and inclusion; [cited 2024 Nov 8]. Available from: https://jbi-global-wiki.refined.site/space/MANUAL/355827799/2.1+Equity,+Diversity,+and+Inclusion
56. White M, Adams J, Heywood P. How and why do interventions that increase health overall widen inequalities within populations?. In Social inequality and public health 2009 Apr 22 (pp. 65-82). Bristol, UK: Policy Press; c2009: p. 65-82. https://doi.org/10.51952/9781847423221.ch005
57. Cochrane Training [Internet]. [place unknown]: Cochrane and Health Equity Thematic Group; 2024 November. [Video], Equity in all Cochrane reviews; [cited 2025 January 22]; [32 min., 52 sec]. Available from: https://training.cochrane.org/resource/equity-in-all-cochrane-reviews
58. Whitehead M. The concepts and principles of equity and health. Int J Health Serv. 1992;22(3):429-45. https://doi.org/10.2190/986l-lhq6-2vte-yrrn
59. Bosch-Capblanch X, Lavis JN, Lewin S, Atun R, Røttingen JA, Dröschel D, Beck L, Abalos E, El-Jardali F, Gilson L, Oliver S, Wyss K, Tugwell P, Kulier R, Pang T, Haines A. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development. PLOS Med. 2012;9(3):e1001185. https://doi.org/10.1371/journal.pmed.1001185
60. Qualtrics. Qualtrics XM. Provo (UT): Qualtrics. c2005 - [updated 2024 March; cited 2024 Nov 14]. Available from: https://www.qualtrics.com
Downloads
Additional Files
Published
How to Cite
License
Copyright (c) 2025 Stacy Torian, Stephen Maher
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
All works in Hypothesis are licensed under a Creative Commons Attribution 4.0 International license. Authors own copyright of their articles appearing in Hypothesis. Readers may copy articles without permission of the copyright owner(s), as long as the author(s) and the Medical Library Association are acknowledged in the copy, and the copy is used for educational, not-for-profit purposes. For any other use of articles, please contact the copyright owner(s).
