Browsing by Author "Schunemann, Holger"

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    Equity issues rarely addressed in the development of COVID-19 formal recommendations and good practice statements: a cross-sectional study
    (2023) Dewidar, Omar; Bondok, Mostafa; Abdelrazeq, Leenah; Aliyeva, Khadija; Solo, Karla; Welch, Vivian; Brignardello-Petersen, Romina; Mathew, Joseph L.; Hazlewood, Glen; Pottie, Kevin; Hartling, Lisa; Khalifa, Dina Sami; Duda, Stephanie; Falavigna, Maicon; Khabsa, Joanne; Lotfi, Tamara; Petkovic, Jennifer; Elliot, Sarah; Chi, Yuan; Parker, Roses; Kristjansson, Elizabeth; Riddle, Alison; Darzi, Andrea J.; Magwood, Olivia; Saad, Ammar; Radav, Gabriel; Neumann, Ignacio; Loeb, Mark; Reveiz, Ludovic; Mertz, Dominik; Piggott, Thomas; Turgeon, Alexis F.; Schunemann, Holger; Tugwell, Peter
    Background and Objective: To identify COVID-19 actionable statements (e.g., recommendations) focused on specific disadvantaged populations in the living map of COVID-19 recommendations (eCOVIDRecMap) and describe how health equity was assessed in the development of the formal recommendations. Methods: We employed the place of residence, race or ethnicity or culture, occupation, gender or sex, religion, education, socio-economic status, and social capital-Plus framework to identify statements focused on specific disadvantaged populations. We assessed health equity considerations in the evidence to decision frameworks (EtD) of formal recommendations for certainty of evidence and impact on health equity criteria according to the Grading of Recommendations, Assessment, Development, and Evaluations criteria.Results: We identified 16% (124/758) formal recommendations and 24% (186/819) good practice statements (GPS) that were focused on specific disadvantaged populations. Formal recommendations (40%, 50/124) and GPS (25%, 47/186) most frequently focused on children. Seventy-six percent (94/124) of the recommendations were accompanied with EtDs. Over half (55%, 52/94) of those considered indirectness of the evidence for disadvantaged populations. Considerations in impact on health equity criterion most frequently involved implementation of the recommendation for disadvantaged populations (17%, 16/94). Conclusion: Equity issues were rarely explicitly considered in the development COVID-19 formal recommendations focused on specific disadvantaged populations. Guidance is needed to support the consideration of health equity in guideline development during health emergencies.& COPY; 2023 Elsevier Inc. All rights reserved.
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    Global access to affordable direct oral anticoagulants
    (2021) Neumann, Ignacio; Schunemann, Holger; Bero, Lisa; Cooke, Graham; Magrini, Nicola; Moja, Lorenzo
    Poor control of cardiovascular disease accounts for a substantial proportion of the disease burden in developing countries, but often essential anticoagulant medicines for preventing strokes and embolisms are not widely available. In 2019, direct oral anticoagulants were added to the World Health Organization's WHO Model list of essential medicines. The aims of this paper are to summarize the benefits of direct oral anticoagulants for patients with cardiovascular disease and to discuss ways of increasing their usage internationally. Although the cost of direct oral anticoagulants has provoked debate, the affordability of introducing these drugs into clinical practice could be increased by: price negotiation; pooled procurement; competitive tendering; the use of patent pools; and expanded use of generics. In 2017, only 14 of 137 countries that had adopted national essential medicines lists included a direct oral anticoagulant on their lists. This number could increase rapidly if problems with availability and affordability can be tackled. Once the types of patient likely to benefit from direct oral anticoagulants have been clearly defined in clinical practice guidelines, coverage can be more accurately determined and associated costs can be better managed. Government action is required to ensure that direct oral anticoagulants are covered by national budgets because the absence of reimbursement remains an impediment to achieving universal coverage. Tackling cardiovascular disease with the aid of direct oral anticoagulants is an essential component of efforts to achieve the World Health Organization's target of reducing premature deaths due to noncommunicable disease by 25% by 2025.
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    Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses
    (2023) Tugwell, Peter; Welch, Vivian; Magwood, Olivia; Todhunter-Brown, Alex; Akl, Elie A.; Concannon, Thomas W.; Khabsa, Joanne; Morley, Richard; Schunemann, Holger; Lytvyn, Lyubov; Agarwal, Arnav; Antequera, Alba; Avey, Marc T.; Campbell, Pauline; Chang, Christine; Chang, Stephanie; Dans, Leonila; Dewidar, Omar; Ghersi, Davina; Graham, Ian D.; Hazlewood, Glen; Hilgart, Jennifer; Horsley, Tanya; John, Denny; Jull, Janet; Maxwell, Lara J.; McCutcheon, Chris; Munn, Zachary; Nonino, Francesco; Pardo, Jordi Pardo; Parker, Roses; Pottie, Kevin; Rada, Gabriel; Riddle, Alison; Synnot, Anneliese; Ghogomu, Elizabeth Tanjong; Tomlinson, Eve; Toupin-April, Karine; Petkovic, Jennifer
    BackgroundInvolving collaborators and partners in research may increase relevance and uptake, while reducing health and social inequities. Collaborators and partners include people and groups interested in health research: health care providers, patients and caregivers, payers of health research, payers of health services, publishers, policymakers, researchers, product makers, program managers, and the public. Evidence syntheses inform decisions about health care services, treatments, and practice, which ultimately affect health outcomes.Our objectives are to:A. Identify, map, and synthesize qualitative and quantitative findings related to engagement in evidence synthesesB. Explore how engagement in evidence synthesis promotes health equityC. Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement in evidence synthesesMethodsOur diverse, international team will develop guidance for engagement with collaborators and partners throughout multiple sequential steps using an integrated knowledge translation approach:1. Reviews. We will co-produce 1 scoping review, 3 systematic reviews and 1 evidence map focusing on (a) methods, (b) barriers and facilitators, (c) conflict of interest considerations, (d) impacts, and (e) equity considerations of engagement in evidence synthesis.2. Methods study, interviews, and survey. We will contextualise the findings of step 1 by assessing a sample of evidence syntheses reporting on engagement with collaborators and partners and through conducting interviews with collaborators and partners who have been involved in producing evidence syntheses. We will use these findings to develop draft guidance checklists and will assess agreement with each item through an international survey.3. Consensus. The guidance checklists will be co-produced and finalised at a consensus meeting with collaborators and partners.4. Dissemination. We will develop a dissemination plan with our collaborators and partners and work collaboratively to improve adoption of our guidance by key organizations.ConclusionOur international team will develop guidance for collaborator and partner engagement in health care evidence syntheses. Incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.