Review Article
Development of a framework to identify research gaps from systematic reviews

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Abstract

Objective

Our objective was to develop a framework to identify research gaps from systematic reviews.

Study Design and Setting

We reviewed the practices of (1) evidence-based practice centers (EPCs), and (2) other organizations that conduct evidence syntheses. We developed and pilot tested a framework for identifying research gaps.

Results

Four (33%) EPCs and three (8%) other organizations reported using an explicit framework to determine research gaps. Variations of the PICO (population, intervention, comparison, outcomes) framework were most common. We developed a framework incorporating both the characterization of the gap using PICOS elements (also including setting) and the identification of the reason(s) why the gap exists as (1) insufficient or imprecise information, (2) biased information, (3) inconsistency or unknown consistency, and (4) not the right information. We mapped each of these reasons to concepts from three common evidence-grading systems.

Conclusion

Our framework determines from systematic reviews where the current evidence falls short and why or how the evidence falls short. This explicit identification of research gaps will allow systematic reviews to maximally inform the types of questions that need to be addressed and the types of studies needed to address the research gaps.

Section snippets

Background and objective

What is new?

Key finding:

  1. A framework was developed to explicitly identify and characterize research gaps from systematic reviews.

What this adds to what was known?
  1. Research gaps prevent systematic reviewers from making conclusions and, ultimately, limit our ability to make informed health care decisions. This framework characterizes where the evidence falls short and how or why the evidence falls short.

What is the implication and what should change now?
  1. Use of the framework promotes an explicit and systematic method of identification and presentation of research gaps from systematic reviews.

Methods

Detailed methods are provided in the report for this Evidence-based Practice Center project funded by the Agency for Healthcare Research and Quality (AHRQ) [8]. We first sought to identify any methods and frameworks being used by organizations to identify gaps from systematic reviews. We conducted an audit of reports from Evidence-based Practice Centers (EPCs). Reports addressing clinical or health care services questions, published since 2008 by current EPCs, were considered. If an EPC had

Results

Twelve reports were included in our audit of EPC reports. All reports included some discussion of future research needs or gaps; in 75%, this was found in the discussion section of the report. None of the reports included a description of how research gaps or needs were identified. We determined that two of the 12 reports used an explicit framework to present the gaps. In both cases, the PICO format was used (population, intervention, comparison, outcomes).

We identified and contacted 64

Conclusions

Systematic reviews are essential to the practice of “evidence-based research.” Health care research should begin and end with a systematic review [16], [17], [18]. A comprehensive and explicit consideration of the existing evidence is necessary for the development of an unanswered and answerable question, for the design of a study most likely to answer that question, and for the interpretation of the results of the study [19]. The identification of gaps from systematic reviews is one way to

Acknowledgments

The authors are grateful to Jodi Segal, MD, MPH, and Steve Goodman, MD, PhD, of the Johns Hopkins University School of Medicine for their expert review of the framework, the worksheet, and the accompanying instructions. They thank the peer reviewers for the report of the AHRQ-funded Evidence-based Practice Center project. They also thank Laura Barnes, BS, for her assistance in abstracting data from EPC evidence reports.

This project was funded under Contract No. HHSA 290-2007-10061-I from the

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