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Evidence Aid, Centre for Global Health, Trinity College Dublin

Evidence Aid Project

 

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Evidence_Aid_LogoThe need for knowledge

People and organisations planning for and responding to natural disasters and other large scale emergencies need access to high quality, unbiased information on what works, doesn’t work and is unproven, if they are to make well-informed decisions that will help individuals and communities to recover. This information has to cover a wide variety of areas, including health, shelter, communication, construction, education, security and support for displaced people. It must be accessible, reliable and up to date. Evidence Aid will achieve this by working with those who require this information, the producers of the information, and others who can transfer knowledge and needs between the producers and the users.

Systematic reviews

Systematic reviews provide the vehicle by which evidence from research can be brought together in ways that minimise bias, avoid undue emphasis on single studies, and maximise the power of work that has already been done. They begin with a focused question and clear eligibility criteria; seek out and appraise the relevant studies; and compare, contrast and, where relevant and possible, combine their findings. They provide decision makers and others making choices with a summary of the available evidence, which can then be combined with other information, such as local values and resources, to take action. An up-to-date systematic review allows well-informed decisions to be taken more quickly and eases the evidence-gathering burden for people who need to take these decisions. The value of systematic reviews is recognised across many disciplines and the concept of drawing on the totality of evidence when making decisions is neither new nor outlandish when explained to researchers, policy makers and the public.

History of Evidence Aid

Evidence Aid was established by The Cochrane Collaboration, the world’s largest organisation dedicated to preparing and maintaining systematic reviews of the effects of healthcare interventions. The initial aim of Evidence Aid was to improve access to information for people and organisations facing health and healthcare challenges that arise in natural disasters and other large scale health emergencies and crises. It grew out of The Cochrane Collaboration’s response to the Indian Ocean tsunami in December 2004, when priorities were identified by people in the affected region and the Collaboration sought to provide relevant evidence. However, there were many gaps in the evidence base, and many problems with getting the information to the people who needed it. This was reinforced when the Collaboration responded to subsequent natural disasters such as the Wenchuan province earthquake in China in 2008, and the Haiti earthquake and Pakistan floods in 2010. It was also clear that although providing access to knowledge after the event can lead to benefits, it needs to be made available earlier as well, to the people and organisations preparing plans and procedures for disaster risk reduction and disaster response. It is also clear that evidence on health care is just one part of the myriad range of knowledge needs for natural disasters, and Evidence Aid is expanding, both in coverage and in partnerships, to provide a resource to meet those needs.

Evidence Aid - now

Evidence Aid has grown since 2004, with a steadily increasing collection of summaries of Cochrane reviews available free of charge on the internet and a limited, unfunded capability to respond to major natural disasters. For example, we provided a collection of resources to the World Health Organisation (WHO) and others within 24 hours of the devastating earthquake in Haiti in January 2010, providing information on interventions that are effective and on those that have been shown to be ineffective in areas such as fracture and wound management, mental health and infectious diseases. In August 2010, we worked with WHO and others on a special collection of Cochrane reviews to assist with the response to the widespread floods in Pakistan. The Cochrane Collaboration funded a formal evaluation of Evidence Aid in 2008/09, which highlighted the need for Evidence Aid to engage more closely with people and organisations involved in disaster risk reduction and response, and to improve awareness of, and accessibility to, its content. We are now implementing the findings of that evaluation.

Evidence Aid - next

In 2010, The Cochrane Collaboration set aside £25,000 to support part of the salary for a coordinator to work on Evidence Aid for an initial period of one year, to establish and strengthen contacts with key agencies in disaster relief. This funding was supplemented by £20,000 from Wiley-Blackwell, as a founding sponsor of Evidence Aid. Wiley-Blackwell have also agreed to provide in-kind support for the development a new website for Evidence Aid and to work with other publishers to facilitate the inclusion of relevant materials from other sources, which would also be free to users. Dr Bonnix Kayabu was appointed as the Evidence Aid coordinator in December 2010, within the Centre for Global Health in Trinity College Dublin, Ireland.

This has allowed Evidence Aid to enter a new phase and to begin to grow beyond health care. The expansion of Evidence Aid will require engagement with evidence providers and knowledge sources in new areas so as to make it easier for those planning for disasters and other large scale emergencies, and for those trying to cope with their aftermath, to make well informed decisions about priorities, needs and responses.

Evidence Aid – the future

If Evidence Aid is to meet the needs of decision makers, it must identify those needs, seek the necessary information and provide this information in a readily accessible form. It will do this through the compilation of a needs-driven collection of systematic reviews. Attached to these reviews will be short, targeted summaries,  highlighting the relevance of the findings to the specific issues being faced and providing ‘headline’ conclusions in a format that will allow decision makers to make choices based on answers to questions about the effects of options available to them. The full text of the review will be available to those who wish to delve into the details and, for those who wish to go deeper by examining the studies upon which the review is based, we will seek to link all of the underlying research papers for the review. Our vision is that this whole collection of knowledge, from the summary, through the systematic review, and into the individual articles will be readily accessible in a timely manner, through a variety of media, including the internet, paper and mobile phone technology. This will require partnerships with researchers, journals and publishers. Where systematic reviews do not exist, we will identify ways to get them done. Where reviews exist but are out of date, we will identify ways to get them updated.

The next steps

Achieving this vision for Evidence Aid will require new partnerships, new funding and new ways to deliver the knowledge. It will require full engagement with the users of the resources, to make the resources fit for purpose, and to ensure that they take appropriate account of local needs and values. Evidence Aid seeks to provide the information that will help people make well-informed decisions, it does not seek to tell people what to do. The recent funding from The Cochrane Collaboration and Wiley-Blackwell will allow this work to begin, building on the foundations that have been laid over the last six years. But, more is needed.

Knowledge needs have to be mapped out to identify the areas of uncertainty that arise in the aftermath of natural disasters across many different areas. Decision nodes will be attached to these pathways, to highlight the points at which evidence from research could provide knowledge that will allow people to make better choices. Relevant evidence will be identified or produced, so that it can be attached to these nodes; and then monitored to ensure that it remains relevant, reliable and up to date. Based on the list of priorities created after the Indian Ocean tsunami, and initial discussions with others engaged in disaster risk reduction and response, several hundred systematic reviews will be needed in health care and beyond. At this time, it seems likely that 200 systematic reviews in health care and 100 systematic reviews in other areas would cover the highest priorities. Approximately half of these healthcare reviews are already completed, but several need to be updated. Evidence Aid needs to begin to map these known reviews and those that are identified outside of the health care, to the priorities.

The identification of gaps will also arise during the development of the pathways and decision nodes that will be key to providing relevant knowledge to people making choices about disaster planning and response. This will be achieved by a thorough assessment of information that has already been gathered following recent natural disasters, and during other situations such as the mass displacement of populations due to famine or war. This will be supplemented by new evaluations, so that these can focus specifically on those aspects of decision making that Evidence Aid is most likely to be able to help with.

The expansion and strengthening of Evidence Aid will help those responsible for making decisions relevant to natural disasters to choose effective strategies and avoid those that are ineffective. It will bring benefits in the aftermath of disasters, as well as helping people making decisions in resource poor settings more generally. It will save lives, reduce morbidity and enable communities to recover quicker and more efficiently.

References

.Tharyan P, Clarke M, Green S. How the Cochrane Collaboration is responding to the Asian Tsunami. PLoS Medicine 2005;2(6):e169.

Clarke M. Evidence Aid - from the Asian tsunami to the Wenchuan earthquake. Journal of Evidence Based Medicine 2008;1:9-11.

Turner TJ, Barnes H, Reid J, Garrubba M. Evidence for perinatal and child health care guidelines in crisis settings: can Cochrane help? BMC Public Health 2010;10:170.

http://www.thecochranelibrary.com/details/collection/587779/Cochrane-Evidence-Aid-resources-for-Chile-and-Haiti-earthquakes.html

http://www.thecochranelibrary.com/details/collection/814673/Water-safety--w%20ater-related-diseases.html

Turner T, Green S, Harris C. Supporting evidence-based health care in crises. What information do humanitarian organizations need? Disaster Medicine and Public Health Preparedness 2010, published online prior to print (October 26 2010).

 

For further information on this research programme please contact Prof. Mike Clarke, Principal Investigator

For more information please visit:

http://www.evidenceaid.org

http://www.cochrane.org

 

Current research

PARTICIPATION IN EVIDENCE AID SURVEY

 

Needs assessment of aid agencies and funding organizations on the use of systematic reviews in disaster settings

We are inviting people working in the humanitarian sector and other related areas to take part in a survey as part of the Evidence Aid project. This  examine the use of systematic reviews by decision-makers involved in, planning for and responding to natural disasters and other humanitarian crises.

 Evidence Aid was initiated by The Cochrane Collaboration and has grown to include new partners. This survey is being carried out in collaboration with the Centre for Global Health, Trinity College Dublin, Ireland and is being supervised by Professor Mike Clarke, from the Centre for Public Health in Queen’s University Belfast, Northern Ireland, (former Director of the UK Cochrane Centre). This survey has been made possible by funding to Evidence Aid from The Cochrane Collaboration, Wiley-Blackwell and the European Union funded TENALEA project", to the cover letter and the survey.

Evidence Aid uses knowledge from Cochrane reviews and other systematic reviews to provide reliable, up-to-date evidence on interventions that might be considered in the context of natural disasters and other major emergencies. We are seeking to highlight which interventions work, which don’t work, which need more research, and which, no matter how well meaning, might be harmful; and to improve access to this information.

Systematic reviews aim to identify, appraise and summarize the findings of relevant research on a given topic, to make the available evidence more accessible to people making decisions and setting policy. They compare and contrast the findings of individual studies, and, when appropriate, combine the results to provide a more reliable and precise estimate of the effect of an intervention, or the association between variables, than is possible with a single study. They can be done in any area of research, but by far the largest proportion currently available are related to health. Cochrane reviews are produced by The Cochrane Collaboration and focus on the effects of healthcare interventions. The Cochrane Collaboration is the world's largest organization dedicated to the production of systematic reviews, with more than 4500 reviews published to date, through the work of 25,000 volunteers in over 100 countries.

Your participation in this survey will help us to draw up a list of priority topics for evidence relevant to needs following natural disasters and other humanitarian emergencies. The priority topics will then be described to allow the identification of potentially relevant systematic reviews and the underlying research. This will supplement the list of topics drawn up following the 2004 Asian-Pacific tsunami, the floods in Pakistan, the earthquake in Haiti and the current Japanese disaster.

This study will contribute to good practice and will enable humanitarian intervention planners and beneficiaries alike to have access to information based on evidence before, during and after natural disasters, and other complex emergencies throughout the world.

Participation in the study is voluntary and entirely confidential – personal details of respondents will not be disclosed.
 
Participants will be able to choose the language they wish to respond in (English, French, Spanish or Arabic).

If you are interested in the survey please contact:

CGH_Staff_BK Dr. Bonnix Kayabu
Coordinator, Evidence Aid
E-mail: kayabumb@tcd.ie)
Landline: +353 1 896 4395

 

 

 

 

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Last updated 23 November 2016 School Web Administrator (Email).