目标:世界卫生组织(WHO)卫生规划和医疗保健提供指南是其在公共卫生领域技术领导的基础,对全球决策至关重要。指南制定的一个关键功能是确定需要进一步证据的领域,因为填补这些空白将导致未来人口健康的改善。这项研究的目的是审查知识差距和研究问题,以解决通过世卫组织指南制定过程产生的差距。目的是为改善和加强指南制定过程的未来战略提供信息。
方法:我们做了一个系统的,对已发布指南中确定的研究问题进行回顾性分析.
方法:我们分析了2008年1月1日至2018年12月31日之间由传染病集群发布的五个疾病领域的指南:结核病(TB),艾滋病毒,疟疾,TB-HIV,被忽视的热带病(NTDs)。研究问题由两名研究人员独立提取。我们分析了按疾病和主题类别划分的研究问题的分布,并对指南制定过程中研究问题生成的最佳实践进行了定性评估。
结果:共包括48个指南:26个关于HIV,1关于疟疾,11关于TB,5关于结核病/艾滋病毒,在NTD上有5个。总的来说,36(75%)指南涵盖了360个明确的研究问题;其余的不包含具体的研究问题。关注结核病的研究问题数量为49个,TB/HIV为38个,HIV为250个,NTDs为23个。专注于诊断的研究问题数量为360个中的43个(11.9%),预防为62个(17.2%),治疗为103(28.6%),良好做法为12(3.3%),服务交付为86(23.8%),其他地区为54(15%)。研究问题通常不是以特定或可操作的方式制定的,并且很难在指南中确定。审查小组确定的良好做法的例子涉及产生具体和狭义的研究问题,并附有适当研究设计的建议。
结论:世界卫生组织必须加强其在指南制定过程中识别和提出研究问题的方法。确保获得研究问题是为指南制定过程增加价值的关键下一步。
OBJECTIVE: World Health Organization (WHO)
guidelines for health programmes and healthcare delivery are the foundation of its technical leadership in public health and essential to decision-making globally. A key function of guideline development is to identify areas in which further evidence is needed because filling these gaps will lead to future improvements in population health. The objective of this study was to examine the knowledge gaps and research questions for addressing those gaps generated through the WHO guideline development process, with the goal of informing future strategies for improving and strengthening the guideline development process.
METHODS: We did a systematic, retrospective analysis of research questions identified in the published
guidelines.
METHODS: We analyzed
guidelines published between January 1, 2008, and December 31, 2018, by the Communicable Diseases Cluster in five disease areas: tuberculosis (TB), HIV, malaria, TB-HIV, and neglected tropical diseases (NTDs). Research questions were extracted independently by two researchers. We analyzed the distribution of research questions by disease and by topic category and did a qualitative assessment of optimum practice for research question generation during the guideline development process.
RESULTS: A total of 48
guidelines were included: 26 on HIV, 1 on malaria, 11 on TB, 5 on TB/HIV, and 5 on NTDs. Overall, 36 (75%)
guidelines encompassed a total of 360 explicit research questions; the remainder did not contain specific research questions. The number of research questions that focused on TB was 49, TB/HIV was 38, HIV was 250, and NTDs was 23. The number of research questions that focused on diagnosis was 43 (11.9%) of 360, prevention was 62 (17.2%), treatment was 103 (28.6%), good practice was 12 (3.3%), service delivery was 86 (23.8%), and other areas was 54 (15%). Research questions were often not formulated in a specific or actionable way and were hard to identify in the guideline. Examples of good practice identified by the review team involved the generation of specific and narrowly defined research questions, with accompanying recommendations for appropriate study design.
CONCLUSIONS: The WHO must strengthen its approach to identifying and presenting research questions during the guideline development process. Ensuring access to research questions is a key next step in adding value to the guideline development process.