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This page is for organizations and initiatives focused on synthesizing evidence and producing clinical guidance to document best practices, tools, resources, needs, and other aspects of their workthe data-to-evidence portion of the knowledge ecosystem cycle. The purpose of the documentation below is to facilitate the uptake of high-quality evidence and guidance into clinical decision support and performance measures, to highlight best practice, and to foster inter-agency cooperation and support within the knowledge ecosystem for COVID-19 and beyondsupport efforts to use data about care delivery and results to generate evidence, meet reporting requirement, and activities. The first set of tables apply broadly to COVID-19 (and other targets), and the second set of tables refer to evidence and guidance specifically related to the Collaborative’s current focus targets; i.e., COVID-19 testing and triage, and anticoagulant use.

Those providing data for these tables should consider, "What do you want those who seek to implement 'living guidance' to know about evidence synthesis and guidance development strategies 'data-to-evidence' strategies, initiatives and tools to make their efforts more successful? Likewise, "What do you want to know about efforts of others working in the knowledge ecosystem to make your data-to-knowledge efforts more successful?"

If you have been requested to provide information for these tables by a project lead and need a Word version to do this, use this document.

Forms from Collaborative Participants

Overarching Description of Evidence Synthesis/Guideline Development Community Best Practices, Tools, Resources

...

Identify (Search/Screen) Primary Studies (See this CoP page)

...

Synthesize Evidence (including Assessing Quality) (See this CoP page)

...

Current 

Approach1

From COVID-END:

Identify published systematic and rapid reviews from trusted sources (including VA ESP Covid-19 Evidence Reviews and Cochrane) and present these in the COVID-END inventory

Categorise into four mutually exclusive taxonomies: clinical management, public health measureshealth system arrangements and economic and social resources.

Add decision-relevant information to each document included in the inventory in order to support easier assessments of relevance, including:

  • flagging review search dates (to support assessments of how up-to-date the evidence is);

appraising and reporting quality using AMSTAR 1 tool (to provide information about the quality of each review);

  • identifying which reviews are living and which have a GRADE evidence profile; and
  • creating declarative titles for ease of understanding and applicability for policymaker end user.

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...

...

From COVID-END

Match response to need (in this case, a prototypical 25-year-old policy analyst being asked by senior decision-makers for best evidence across a broad range of issues on very short timelines)

Use an online administrative interface for processing records (rather than Excel) and a more elegant front-end solution for displaying the inventory

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Notes from 10/16/20 email exchange

From JO:

"No question that 'data to evidence' is critical to the Collaborative's knowledge ecosystem enhancement effort.  Sandy asked to be included in the exploration, and Sara and Brian mentioned in the chat too - all copied on this note. Also looping in Jenna, whom you noted has been a partner for you in representing this need throughout the ACTS journey, and Ben Hamlin, who may be very interested in this as well. Including Surbi, Chris and Matt, since the UMN anticoagulation results could be part of an effort to demonstrate better flow through this link.

It would be great to strengthen how we're attending to this link in the chain - especially critical in the COVID-19 era. We could establish a new 'Collaborative Participant Window' devoted to this link in the cycle (i.e., "Apply Results (QI/Create Evidence)"). If we do this, would you be able to shepherd contributions to this page (along with other interested) and work with me to make sure we're connecting the best we're surfacing about this link with the other links we're working on in the Collaborative?"

From BA:

"EBMonFHIR (COKA) works at the “evidence part” of the knowledge ecosystem and FHIR.   “Evidence to Guidance” as you know works with CPGonFHIR, CDC ACG, C19, etc. and the HL7 CDS Work Group

In the other direction (“Data to Evidence”) participants include HL7 Biomedical Research and Regulation (BRR) work group and an HL7 FHIR Accelerator named Vulcan.   We are helping BRR map out FHIR ResearchStudy and FHIR ResearchSubject resources."

From MM:

"Partially echoing Brian, the “data to evidence” part of the cycle includes some aspects of research but also things like public health and quality reporting.

So in addition to groups like HL7 BRR and Vulcan, there’s also Da Vinci (quality reporting), and Making EHR Data More Available for Research and Public Health (MedMorph) (research and public health data exchange) that all fall into the “category” that I think we’ve been leaving out in our ACTS discussions."

From MB:

"Related to DaVinci, should include DEQM- Data Exchange for Quality Measurement.

The "Rosetta Stone"/ Holy Grail would be to use the same Concepts/Terms/Codes as appropriate throughout the entire cycle, NOT just the same Terminology Systems.  And I won't even go down the path of using the same Information Model as both are needed to get truly accurate semantics (OM.  CC-in Victor Lee and Andy Kanter in this regard."



Overarching Description of Data-to-Evidence Community Best Practices, Tools, Resources, Initiatives (see especially 'Apply Results' column at the end of these tables)


From COVID-END

Identify (Search/Screen) Primary Studies (See this CoP page)

Synthesize Evidence (including Assessing Quality) (See this CoP page)

Current 

Approach1




Pearls/Tips Learned/Tools


Desired Approach

Needs to Achieve Desired Approach

Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

__Other [Details:]


From COVID-END:

_x_Better source/input materials [Details: ] Harvest from all high-yield, high-quality sources

_x_Common format/terminologies for managing/sharing data [Details: ] COVID-END taxonomy

_x_Consistency of outcomes [Details:]

_x_Engagement with primary researchers and upstream stakeholders [Details: When gaps in the best-available evidence related to the pandemic response are identified (e.g., a taxonomy category in the inventory has no high-quality evidence synthesis available) engaging researchers and research funders may help to set priorities for research needed to fill gaps)]

_x_Engagement with decision makers and other downstream stakeholders [Details:] Regulator interactions with government officials in many Canadian provinces and in many other countries

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Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

__Consistency of outcomes [Details:]

__Engagement with primary researchers and upstream stakeholders [Details:]

__Engagement with decision makers and other downstream stakeholders [Details:]

__Other [Details:]

Support You Can Provide Other Participants

The COVID-END Inventory aims to identify best current evidence in the four taxonomies, and to identify those reviews that are living, up to date, high quality and where there is a GRADE evidence profile. Inventory also provides link to the underlying reviews in addition to outputs described above.

COVID-END has also established an international horizon scanning group that meets monthly, an equity group that aims to identify means of increasing the visibility of measures aimed at reducing inequity, and aims also to commission living systematic reviews to address high priority areas that may not have been sufficiently addressed by evidence synthesis researchers.

Further outputs include resources for researchers and guidelines developers that are proposing to conduct a systematic review or develop clinical practice guidelines – aimed at reducing inadvertent and inappropriate duplication of effort and increasing the quality of reviews and guidelines produced

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  For this row and the next, include URLs/pointers to documents outlining steps to accomplish the tasks, tools that support this work and/or other items critical for others working along the evidence/knowledge to know about to make their work optimally efficient, appropriate and effective.





Produce Guidance (See this CoP page)

Make Guidance Computable (See this CoP page)

Current 

Approach



Pearls/Tips Learned/Tools

Desired Approach

Needs to Achieve Desired Approach

Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

__Other [Details:]

Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

__Other [Details:]

Support You Can Provide Other Participants

...

Stakeholders can place comments at the bottom of any Learning Community page. If you need editing access to these Participant Window pages, please contact support@ahrq-acts.org.



Drill Down into Evidence Synthesis/Guideline Development into Data-to-Evidence Community Best Practices, Tools, Resources, Initiatives For ACTS Collaborative Focus TargetsTargets  (see especially 'Apply Results' column at the end of these tables)


COVID-19 Testing/Triage (ED and ambulatory settings)

...

Rapid Cochrane review on anticoagulation in COVID-19 patients

Identify (Search/Screen) Primary Studies

Synthesize Evidence (including Assessing Quality)

Current 

Approach



Pearls/Tips Learned/Tools

Desired Approach

Needs to Achieve Desired Approach

Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

__Other [Details:]


Check all that apply

__Better source/input materials [Details: ]

__Common format/terminologies for managing/sharing data [Details: ]

__Consistency of outcomes [Details:]

__Engagement with primary researchers and upstream stakeholders [Details:]

__Engagement with decision makers and other downstream stakeholders [Details:]

__Other [Details:]

Support You Can Provide Other Participants

...