ProjectsNIHR Evidence Synthesis Group (LACES)LACES work in progress
LACES work in progress

Implementation of screening guidance/programmes for diabetic eye: A systematic map

This project involves developing a systematic map of the evidence on the implementation of screening programmes for diabetic eye. Diabetic eye (or diabetic retinopathy) is the most frequent complication of diabetes and leading cause of visual loss and blindness if left untreated. National screening programmes for diabetic eye have had a large impact on improving outcomes. These programmes have well-structured end-to-end pathways that ensure effective delivery of the test followed by diagnosis and links to appropriate treatment services. However, a present, it is not clear how much evidence is available on the implementation of diabetic eye screening programmes, which parts of the end-to-end pathway have been examined, and which outcomes have been measured and reported. To keep abreast of the innovations and screening practices related to diabetic eye screening, this review aims to map research on the implementation of diabetic eye screening programmes across the UK and four developed countries that have relatively similar health systems to that of the UK: Australia, Canada, New Zealand, and the Republic of Ireland. 

A logic model would provide a framework for understanding the various factors and outcomes that are relevant to screening programme implementation. Then, summarising what evidence is available on all aspects of the logic model through a systematic evidence map will allow better formulation of research questions for evidence synthesis and reduce evidence waste in primary studies by identifying areas of research need. This map will also aid in identifying various implementation strategies and screening research priorities in diabetic eye screening and provide insight that could be transferable to other large scale targeted screening programs. It is hoped that this will lead to an evidence-based approach to understanding the key components that facilitate the effective implementation of large national targeted health screening programmes in the UK.

Towards meeting the evidence needs of public health decision-makers: Synthesising evidence using Whole Outcomes and Whole Systems (WOWS) Evidence for Childhood Health

This project has been developed to address two key differences – identified in previous co-produced work – between the focus of researchers and the needs and expectations of those using and impacted by the evidence. More specifically, we are looking at how we can improve the different parts and approaches to the methodology that we use to synthesise evidence for different stakeholders (for example, formal systematic reviews or systematic maps). Such evidence is used to design policies and make decisions about interventions at global and national levels. 

The topic we are focussing on for this project is understanding what broader markers of child health, including those associated with healthy eating, physical activity and mental health for example, may better reflect the concerns of policy-makers, practitioners and those affected by such decisions about their/their child’s health in relation to local contexts. 

We aim to:

  1. Explore how co-production can help prioritise pathways and overlapping factors within and surrounding the child (complex systems) that influence patterns of health around areas of interest (e.g. healthy eating, physical activity and mental health).  
  2. Determine how to use existing data to help our understanding of the way in which these pathways affect aspects of child health. 
  3. Identify what interventions are shown to positively or negatively affect pathways associated with better or worse health. 

Better design evidence synthesis methodology to capture contextual factors in a more helpful way to inform decision-makers about potential success.

 

Funded by NIHR

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