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The method enables a diverse range of evidence types to be synthesized in order to examine potential relationships between a public health environment and outcomes.
While systematic review methods were initially developed for the purpose of synthesising randomised controlled trials, a growing interest in such reviews in the social sciences has led to the development of methods for synthesising a range of evidence types, including qualitative evidence, commentaries and expert opinion (Joanna Briggs Institute 2014; Oliver 2015).
Scoping reviews can also incorporate a range of evidence types, but differ from a systematic review in that the evidence is summarised to provide an overview, or map, of the available evidence, rather than a set of synthesised findings (Arksey and O'Malley 2005).
Outcomes will be addressed by a range of evidence types and analytical techniques (see figure 1).
Here we describe the Evidence Ontology (ECO), developed to characterize a range of evidence types in support of scientific conclusions.
Table 1 highlights the wide range of evidence types present in the climate and health literature, including observational, experimental, and modeling studies, systematic reviews, and meta-analyses.
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It is possible to connect any number of evidence types with a wide range of experimentally or computationally supported assertions.
The type and range of evidence precluded meta-analysis and we therefore performed a narrative synthesis, differentiating clinical outcomes (eg, mobilisation, mortality and morbidity and length of hospital stay), patient-reported outcomes (eg, patient experience and satisfaction), resource use in secondary care (eg, workforce utilisation and costs) and implementation case studies.
A wide range of evidence was drawn together and graded, using systems such as Bandolier (a health evidence-grading system).
As noted above, a wide range of different types of evidence is available, although the body of evidence on a particular topic may be more narrow.
During this time, the KTAs gathered a range of different types of evidence a) Research based articles, b) Reports from other implementation studies, c) Government policy or guidance documents, d) Interview/questionnaire data and e) Health databases.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com