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"Munn, Z."
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Scoping reviews and their role in identifying research priorities
by
Khalil, H.
,
Godfrey, C.M.
,
Evans, C.
in
Biomedical Research
,
Decision making
,
Emergency medical care
2025
Scoping reviews have been identified as appropriate methodologies to contribute to our knowledge. The objective of this review is to summarize how scoping reviews can be used to identify research priorities.
Based on our experience as evidence synthesis methodologists and researchers, the Joanna Briggs Institute (JBI) scoping review methodology group, have identified the potential roles of scoping reviews in identification of research priorities.
Scoping reviews typically ask broad questions that allow researchers to obtain an overview or map of the existing evidence. Scoping reviews also incorporate multiple levels of evidence that enriches the strength of the knowledge that is gained. This value is revealed by the use of scoping reviews to contribute to and perform the following functions: 1) map a research area and identify gaps that need to be addressed; 2) prioritize research topics by identifying key issues to investigate; 3) identify the type of study designs that have been used to investigate a particular topic, and/or the range of outcomes measured following a specific intervention; 4) identify the essential contextual factors that are relevant to the study of a particular research topic; 5) identify equity issues in the research field; 6) assist in engaging stakeholders and/or experts in the field by facilitating the inclusion of these stakeholders within the research process; and 7) provide the relevant new knowledge to enhance and support applications for funding.
To ensure this contribution to identifying research priorities is reliable, scoping reviews must be performed following the existing rigorous methodological processes and adhere to the currently available reporting guidelines. By doing so, scoping reviews have great potential to identify research priorities, to guide the expansion of research and the generation of new knowledge.
•Scoping reviews offer a broad evidence map including research priorities.•Seven methods show how scoping reviews pinpoint research priorities.•They include mapping gaps, topic prioritization, study designs, and context.•They cover equity, stakeholder engagement, and funding advocacy.•Scoping reviews act as synthesis tools to set research priorities.
Journal Article
Guideline registries and libraries: a mixed-methods approach identified issues to be addressed with content
2022
To establish what GIN guideline community members see as the desirable features of a guidelines library and registry of guidelines in development
An explorative mixed-methods study was undertaken, including scoping activity and semi-structured interviews with guideline developers and endorsers from nine member organizations of the Guidelines International Network.
A small number of desirable features of a guideline library were identified: comprehensiveness; single source of information to avoid searching multiple sites; inclusion of related materials; being up to date; searchability and ease of use. No existing library of guidelines was considered to have all of these features. A number of issues arose out of the desire to have a comprehensive library of guidelines, including inclusion of ‘high quality guidelines’ and limiting the scope to include only national guidelines. For registries of guidelines in development, the data set should be limited to avoid placing undue burden on those entering information.
Our findings identify ongoing issues for the guideline community, including the tension between comprehensiveness and ease of use, which can result in limited uptake, reporting of guideline quality and the need for clarity on the purpose of any library or registry.
Journal Article
What Indigenous Australian clients value about primary health care: a systematic review of qualitative evidence
2017
To synthesise client perceptions of the unique characteristics and value of care provided in Aboriginal Community Controlled Health Organisations (ACCHOs) compared to mainstream/general practitioner services, and implications for improving access to quality, appropriate primary health care for Indigenous Australians.
Standardised systematic review methods with modification informed by ethical and methodological considerations in research involving Indigenous Australians.
Perceived unique valued characteristics of ACCHOs were: 1) accessibility, facilitated by ACCHOs welcoming social spaces and additional services; 2) culturally safe care; and 3) appropriate care, responsive to holistic needs.
Provider‐client relationships characterised by shared understanding of clients' needs, Indigenous staff, and relationships between clients who share the same culture, are central to ACCHO clients' perceptions of ACCHOs' unique value. The client perceptions provide insights about how ACCHOs address socio‐economic factors that contribute to high levels of chronic disease in Indigenous communities, why mainstream PHC provider care cannot substitute for ACCHO care, and how to improve accessibility and quality of care in mainstream providers.
To increase utilisation of PHC services in Indigenous Australian communities, and help close the gaps between the health status of Indigenous and non‐Indigenous Australians, Indigenous community leaders and Australian governments should prioritise implementing effective initiatives to support quality health care provision by ACCHOs.
Journal Article
The role of scoping reviews in reducing research waste
2022
Scoping reviews and evidence map methodologies are increasingly being used by researchers. The objective of this article is to examine how scoping reviews can reduce research waste.
This article summarizes the key issues facing the research community regarding research waste and how scoping reviews can make an important contribution to the reduction of research waste in both primary and secondary research.
The problem of research waste is an enduring challenge for global health, leading to a waste of human and financial resources and producing research outputs that do not provide answers to the most pressing research questions. Research waste occurs within primary research but also in secondary research such as evidence syntheses. The focus of scoping reviews on characterizing the nature of existing evidence on a topic and including all types of evidence, potentially reduces research waste in five ways: (1) identifying key research gaps on a topic, (2) determining appropriate outcome measures, (3) mapping existing methodological approaches, (4) developing a consistent understanding of terms and concepts used in existing evidence, and (5) ensuring scoping reviews do not exacerbate the issue of research waste.
To ensure that scoping reviews do not themselves end up contributing to research waste, it is important to register the scoping review and to ensure that international reporting standards and methodological guidance are followed.
Journal Article
Reducing HIV-related stigma and discrimination in healthcare settings: a systematic review of guidelines, tools, standards of practice, best practices, consensus statements and systematic reviews
by
Munn, Zachary
,
Lockwood, Craig
,
Woldie, Mirkuzie
in
Acquired immune deficiency syndrome
,
AIDS
,
Best practice
2018
Policy makers and health professionals prefer to use preappraised and summarized evidence. Stigma and discrimination (SAD) reduction activities and programs are needed to improve the quality of care delivered to people living with HIV and the success of HIV-related prevention, care and treatment programs. The objective of this review was to identify and describe systematic reviews, best practices, consensus statements, standards of practice and guidelines that addressed SAD among healthcare workers (HCWs).
All documents in the form of systematic reviews, best practices, consensus statements, standards of practice and guidelines were considered for inclusion. The search strategy aimed to find both published and unpublished studies reported in English with unlimited date range in Excerpta Medica Database from Elsevier (EMBASE), Cumulative Index to Nursing and Allied Health (CINAHL), Psychological Information (PsycINFO) database and Medical Literature Analysis and Retrieval System Online (MEDLINE). Websites of organizations and guideline databases were also searched. Two individuals independently appraised the quality of the documents using the Appraisal of Guidelines for Research and Evaluation (AGREE II) checklist and the Joanna Briggs Institute critical appraisal checklist for systematic reviews. Data extraction was done using a customized tool that was developed to record the key information of the source that is relevant to the review question.
Twelve records (six guideline-related documents and six systematic reviews) were included in the review. Interventions and recommendations developed to reduce HIV-related SAD were categorized into information-based, structural, biomedical, counseling and support, skills building and contact interventions.
Implications for practice: Interventions that reduce HIV-related SAD are broadly categorized into information-based, structural, biomedical, counseling and support, skills building and contact interventions. Because of limited methodological description of the included documents, it was difficult to draw recommendations for policy and practice.
Future studies need to use up-to-date instruments to measure SAD. Further studies of greater methodological quality are needed. Guidelines, tools and best practice documents that aim to reduce HIV-related SAD should be developed with the considerations of research evidence on the specific setting and specific targeted populations.
Journal Article
Homophily and Segregation in Cooperative Networks1
2020
Social networks affect individuals’ ability to solve conflicts between individual and collective interests. Indeed, the ability to seek out cooperative others is a key explanation for the high levels of cooperation observed in social life. In contrast to existing research on cooperation and networks, sorting in the real world is typically driven by homophily, or similarity on socially significant attributes like ethnicity or religion. Here the authors develop and test an argument about how homophily alters network dynamics and cooperation using a large web-based experiment and an agent-based model. They find that homophily promotes cooperation, net of key determinants of cooperation. Further, homophily drives the selection of new ties, increasing clustering in dynamic networks. The authors also demonstrate the consequences of in-group preferences for between-group segregation. Their results therefore shed light on how cooperation can evolve in networks and how this process contributes to network-level segregation.
Journal Article
Homophily and Segregation in Cooperative Networks
2020
Social networks affect individuals’ ability to solve conflicts between individual and collective interests. Indeed, the ability to seek out cooperative others is a key explanation for the high levels of cooperation observed in social life. In contrast to existing research on cooperation and networks, sorting in the real world is typically driven by homophily, or similarity on socially significant attributes like ethnicity or religion. Here the authors develop and test an argument about how homophily alters network dynamics and cooperation using a large web-based experiment and an agent-based model. They find that homophily promotes cooperation, net of key determinants of cooperation. Further, homophily drives the selection of new ties, increasing clustering in dynamic networks. The authors also demonstrate the consequences of in-group preferences for between-group segregation. Their results therefore shed light on how cooperation can evolve in networks and how this process contributes to network-level segregation.
Journal Article
Phase Ia study of the indoleamine 2,3-dioxygenase 1 (IDO1) inhibitor navoximod (GDC-0919) in patients with recurrent advanced solid tumors
2018
Background
Indoleamine-2,3-dioxygenase 1 (IDO1) catalyzes the oxidation of tryptophan into kynurenine and is partially responsible for acquired immune tolerance associated with cancer. The IDO1 small molecule inhibitor navoximod (GDC-0919, NLG-919) is active as a combination therapy in multiple tumor models.
Methods
This open-label Phase Ia study assessed safety, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary anti-tumor activity of navoximod in patients with recurrent/advanced solid tumors, administered as 50-800 mg BID on a 21/28 day and at 600 mg on a 28/28 day schedule. Plasma kynurenine and tryptophan were longitudinally evaluated and tumor assessments were performed.
Results
Patients (
n
= 22) received a median of 3 cycles of navoximod. No maximum tolerated dose was reached. One dose-limiting toxicity of Grade 4 lower gastrointestinal hemorrhage was reported. Adverse events (AEs) regardless of causality in ≥20% of patients included fatigue (59%), cough, decreased appetite, and pruritus (41% each), nausea (36%), and vomiting (27%). Grade ≥ 3 AEs occurred in 14/22 patients (64%), and were related to navoximod in two patients (9%). Navoximod was rapidly absorbed (T
max
~ 1 h) and exhibited dose-proportional increases in exposure, with a half-life (t
1/2
~ 11 h) supportive of BID dosing. Navoximod transiently decreased plasma kynurenine from baseline levels with kinetics consistent with its half-life. Of efficacy-evaluable patients, 8 (36%) had stable disease and 10 (46%) had progressive disease.
Conclusions
Navoximod was well-tolerated at doses up to 800 mg BID decreasing plasma kynurenine levels consistent with its half-life. Stable disease responses were observed.
Trial registration
ClinicalTrials.gov identifier:
NCT02048709
.
Journal Article
Shared Genetic Factors Contributing to the Overlap between Attention-Deficit/Hyperactivity Disorder Symptoms and Overweight/Obesity in Swedish Adolescent Girls and Boys
by
Larsson, Henrik
,
Thornton, Laura M.
,
Munn-Chernoff, Melissa A.
in
Adolescent
,
Attention Deficit Disorder with Hyperactivity - epidemiology
,
Attention Deficit Disorder with Hyperactivity - genetics
2022
Attention-deficit/hyperactivity disorder (ADHD) and obesity are positively associated, with increasing evidence that they share genetic risk factors. Our aim was to examine whether these findings apply to both types of ADHD symptoms for female and male adolescents. We used data from 791 girl and 735 boy twins ages 16−17 years to examine sex-specific phenotypic correlations between the presence of ADHD symptoms and overweight/obese status. For correlations exceeding .20, we then fit bivariate twin models to estimate the genetic and environmental correlations between the presence of ADHD symptoms and overweight/obese status. ADHD symptoms and height/weight were parent- and self-reported, respectively. Phenotypic correlations were .30 (girls) and .08 (boys) for inattention and overweight/obese status and .23 (girls) and .14 (boys) for hyperactivity/impulsivity and overweight/obese status. In girls, both types of ADHD symptoms and overweight/obese status were highly heritable, with unique environmental effects comprising the remaining variance. Furthermore, shared genetic effects explained most of the phenotypic correlations in girls. Results suggest that the positive association of both types of ADHD symptoms with obesity may be stronger in girls than boys. Further, in girls, these associations may stem primarily from shared genetic factors.
Journal Article