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"Evidence Gaps"
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Methodological approaches to study context in intervention implementation studies: an evidence gap map
by
Zullig, Leah L.
,
Mielke, Juliane
,
De Geest, Sabina
in
Analysis
,
Context effects (Psychology)
,
Contextual analysis
2022
Background
Within implementation science studies, contextual analysis is increasingly recognized as foundational to interventions' successful and sustainable implementation. However, inconsistencies between methodological approaches currently limit progress in studying context and guidance to standardize the use of those approaches is scant. Therefore, this study's objective was to systematically review and map current methodological approaches to contextual analysis in intervention implementation studies. The results would help us both to systematize the process of contextual analysis and identify gaps in the current evidence.
Methods
We conducted an evidence gap map (EGM) based on literature data via a stepwise approach. First, using an empirically developed search string, we randomly sampled 20% of all intervention implementation studies available from PubMed per year (2015–2020). Second, we assessed included studies that conducted a contextual analysis. Data extraction and evaluation followed the Basel Approach for CoNtextual ANAlysis (BANANA), using a color-coded rating scheme. Also based on BANANA and on the Context and Implementation of Complex Interventions (CICI) framework–an implementation framework that pays ample attention to context– we created visual maps of various approaches to contextual analysis.
Results
Of 15, 286 identified intervention implementation studies and study protocols, 3017 were screened for inclusion. Of those, 110 warranted close examination, revealing 22% that reported on contextual analysis.
Only one study explicitly applied a framework for contextual analysis. Data were most commonly collected via surveys (
n
= 15) and individual interviews (
n
= 13). Ten studies reported mixed-methods analyses. Twenty-two assessed meso-level contextual and setting factors, with socio-cultural aspects most commonly studied. Eighteen described the use of contextual information for subsequent project phases (e.g., intervention development/adaption, selecting implementation strategies). Nine reported contextual factors' influences on implementation and/or effectiveness outcomes.
Conclusions
This study describes current approaches to contextual analysis in implementation science and provides a novel framework for evaluating and mapping it. By synthesizing our findings graphically in figures, we provide an initial evidence base framework that can incorporate new findings as necessary. We strongly recommend further development of methodological approaches both to conduct contextual analysis and to systematize the reporting of it. These actions will increase the quality and consistency of implementation science research.
Journal Article
Chewing Gum and Health: A Mapping Review and an Interactive Evidence Gap Map
by
Cagetti, Maria Grazia
,
Salerno, Claudia
,
Cirio, Silvia
in
Analysis
,
Athletic Performance
,
Chewing Gum
2025
Background: Chewing gum is a simple, accessible tool with high user compliance, traditionally associated with oral health benefits. Although its potential effects on different aspects of health and well-being, beyond its oral applications, have been explored, the area remains relatively under-researched. This mapping review and evidence gap map (EGM) aimed to evaluate the existing literature on the non-oral health applications of chewing gum and to identify gaps in the literature. Methods: A comprehensive search was conducted across five databases (Scopus, Embase, PubMed, PsycINFO, and CINAHL) using tailored search strategies. Abstracts were screened against predefined eligibility criteria using EPPI-Reviewer version 6, with full texts reviewed only when relevant information could not be drawn. The included studies were coded by gum type, outcome, and study design, and the EGM was constructed using EPPI-Mapper version 2.4.5. Results: Of the 2614 identified records, 1326 were screened after duplicate removal, and 260 studies were included in the final analysis. Three main areas of application emerged: for enhancing well-being and performance, as a medical aid and as a surgical/procedural aid. The EGM indicated that the most frequently studied uses of chewing gum were in sports performance, smoking cessation, and post-operative recovery. However, notable research gaps were found, particularly in paediatric and geriatric contexts. Conclusions: Chewing gum has been extensively studied as a surgical or procedural aid, particularly for post-operative gastrointestinal recovery, but its broader applications for well-being, performance, and its use in paediatric and elderly populations remain underexplored. Further high-quality research using standardised methodologies is needed to address these gaps.
Journal Article
Preconception Care Interventions for Adolescents and Young Adults to Prevent Adverse Maternal and Child Health Outcomes: Protocol for an Evidence Gap Map
2024
Preconception is the period before a young woman or woman conceives, which draws attention to understanding how her health condition and certain risk factors affect her and her baby's health once she becomes pregnant. Adolescence and youth represent a life-course continuum between childhood and adulthood, in which the prepregnancy phase lacks sufficient research.
The aim of the study is to identify, map, and describe existing empirical evidence on preconception interventions that enhance health outcomes for adolescents, young adults, and their offspring.
We will conduct an evidence gap map (EGM) activity following the Campbell guidelines by populating searches identified from electronic databases such as MEDLINE, Embase, CINAHL, and Cochrane Library. We will include interventional studies and reviews of interventional studies that report the impact of preconception interventions for adolescents and young adults (aged 10 to 25 years) on adverse maternal, perinatal, and child health outcomes. All studies will undergo title or abstract and full-text screening on Covidence software (Veritas Health Innovation). All included studies will be coded using the Evidence for Policy and Practice Information (EPPI) Reviewer software (EPPI Centre, UCL Social Research Institute, University College London). Cochrane Risk of Bias tool 2.0 and Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2) tool will be used to assess the quality of the included trials and reviews. A 2D graphical EGM will be developed using the EPPI Mapper software (version 2.2.4; EPPI Centre, UCL Social Research Institute, University College London).
This EGM exercise began in July 2023. Through electronic search, 131,031 publications were identified after deduplication, and after the full-text screening, 18 studies (124 papers) were included in the review. We plan to submit the paper to a peer-reviewed journal once it is finalized, with an expected completion date in May 2024.
This study will facilitate the prioritization of future research and allocation of funding while also suggesting interventions that may improve maternal, perinatal, and child health outcomes.
DERR1-10.2196/56052.
Journal Article
An Evidence Gap Map of Experience-based Evidence of Health Resource Allocation in Disaster and Humanitarian Settings
2024
The aim of this review is to identify, evaluate, and graphically display gaps in the literature related to scarce health resource allocation in humanitarian aid settings.
A systematic search strategy was utilized in MEDLINE (via Ovid), Scopus, EMBASE, CINAHL Complete, and ProQuest Central. Articles were reviewed by 2 reviewers with a third reviewer remedying any screening conflicts. Articles meeting inclusion criteria underwent data extraction to facilitate evaluation of the scope, nature, and quality of experience-based evidence for health resource allocation in humanitarian settings. Finally, articles were mapped on a matrix to display evidence graphically.
The search strategy identified 6093 individual sources, leaving 4000 for screening after removal of duplicates. Following full-text screening, 12 sources were included. Mapping extracted data according to surge capacity domains demonstrated that all 4 domains were reflected most of all the staff domain. Much of the identified data was presented without adhering to a clear structure or nomenclature. Finally, the mapping suggested potential incompleteness of surge capacity constructs in humanitarian response settings.
Through this review, we identified a gap in evidence available to address challenges associated with scarce resource allocation in humanitarian settings. In addition to presenting the distribution of existing literature, the review demonstrated the relevance of surge capacity and resource allocation principles underpinning the developed framework.
Journal Article
Virtual clinical simulation as a pedagogical strategy in healthcare learning: Evidence and gap map
by
Engler, Jamille Costa
,
Amadigi, Felipa Rafaela
,
Guesser, Joice Cristina
in
Bibliographic Databases
,
Clinical Competence
,
Clinical medicine
2026
To map and characterize, systematically, the volume, scope and distribution of systematic review evidence on virtual clinical simulation in healthcare education, describing the educational outcomes assessed, the contexts and modalities where virtual simulations have been implemented and the main evidence gaps identified.
Virtual clinical simulations are increasingly used to support healthcare education and training. However, existing evidence on their effectiveness remains fragmented, with variations in methodological quality and scope.
Evidence and Gap Map (EGM) following Campbell Collaboration Guidance.
A systematic search was conducted across nine databases and two gray literature sources. Eligible studies included systematic reviews examining healthcare professionals or students using virtual simulations. Data were extracted using the PICOS framework and reviewed independently by two researchers. Methodological quality was assessed using AMSTAR-2 and confidence in findings was appraised using CERQual.
A total of 118 reviews met inclusion criteria: 91 systematic, 25 scoping and 2 umbrella reviews. Most were published within the past four years and originated from high-income countries. We identified seven categories across the results: (1) Learning and Knowledge Acquisition; (2) User Perception; (3) Development of Technical Skills; (4) Simulation Performance; (5) Development of Practical Skills; (6) Transfer to Real Clinical Practice; and (7) Program Effectiveness. More than half of the systematic reviews were rated as low or critically low quality, with only 10 % achieving high methodological rigour.
Virtual clinical simulations demonstrate potential to enhance learning outcomes in healthcare education. However, evidence is limited by uneven methodological quality, concentration in high-income settings and a lack of research on emerging technologies and long-term educational impacts. Future high-quality, comparative studies are needed to strengthen the evidence base.
Journal Article
Research Priorities for Diabetic Ketoacidosis: An Evidence and Gap Mapping Review
2025
Background/Objectives: Diabetic ketoacidosis (DKA) is a common acute complication of diabetes with treatment consisting of reversal of cause, insulin administration, fluid resuscitation and electrolyte repletion. Yet, many aspects of DKA management are currently based on low-quality evidence or physiological rationale. This evidence and gap map review presents an overview of the current body of literature and identifies evidence gaps in relation to therapeutic interventions for DKA. Methods: Interventions and outcomes relevant to DKA were identified and iteratively developed to produce a coding model for the proposed evidence and gap map. PubMed was searched with Me SH terms relevant to the identified interventions and outcomes. Studies identified were screened and assigned interventions and outcomes. Interventional research was uploaded to EPPI-Reviewer and EPPI-Mapper to produce the evidence and gap map. Results: The search identified 1131 studies, of which 18 were non-human and 345 were duplicates. A total of 768 unique studies were screened, and 118 were identified as interventions (52 pediatric and 66 adult studies). A total of 26 high-quality studies, 88 medium-quality studies and 4 low-quality studies were identified. These 118 studies were coded into the proposed DKA evidence and gap map. The intervention domains were fluid therapy, insulin therapy, electrolyte replacement, adjunct therapies and admission type. The outcome domains were DKA resolution, insulin duration, length of stay, morbidity and mortality, complications, and biochemical parameters. Conclusions: Fluid type and insulin infusion administration were prominent in the current literature. These studies frequently used DKA resolution and complications associated with DKA such as electrolyte disturbances and cerebral edema as the primary outcomes. Substantial gaps were identified with scant evidence to guide prophylactic electrolyte administration, enteral intake and adjunctive therapy (thiamine, bicarbonate). Even for well-investigated interventions such as fluids and insulin, substantial gaps existed, particularly for patient-centered and healthcare service outcomes.
Journal Article
The Influence of Playing Position on Physical, Physiological, and Technical Demands in Adult Male Soccer Matches: A Systematic Scoping Review with Evidence Gap Map
by
Martinho, Diogo V.
,
Field, Adam
,
Silva, Rui
in
Adult
,
Athletic Performance - physiology
,
Classification
2024
Background
There has been an increase in studies examining the demands of soccer relative to each playing position in recent years. Understanding the physical, physiological, and technical demands on soccer players according to their positional role during competitive matches is necessary to understand match requirements and develop position-specific training practices. Thereby, there is a clear need to synthesize the information on the different profiles of each playing position.
Objective
This review aimed to organize the literature investigating physical, physiological, and technical demands according to playing positions and provide a framework to identify gaps and suggestions for future studies.
Methods
A systematic search was conducted in October 2023 using four electronic databases: Web of Science, SPORTDiscus, PubMed and Scopus. The review followed PRISMA 2020 guidelines and the PRISMA-ScR extension for Scoping Reviews. The studies were included if the sample comprised adult male soccer players categorized from Tier 3 to Tier 5 (i.e., highly trained/national level, elite/international level, or world class) and compared the physical, physiological, or technical parameters across playing positions.
Results
A total of 178 studies met the inclusion criteria and were included in the review. The number of teams, players, and matches analyzed per study varied considerably. Although a range of classifications were reported across studies, 59% of studies classified players as central defenders, full-backs, central midfielders, wide midfielders, and forwards. The findings suggests that central and external midfielders, and external defenders cover greater total and high-speed distance than forwards or central defenders. Sprint distance was higher in external midfielders versus all other positions. Defenders and central midfielders perform more passes than external midfielders and forwards. Heart rate was the most commonly reported physiological variable across playing positions. When expressed as a percentage of maximal heart rate, midfielders presented higher mean values than all other playing positions.
Conclusion
This scoping review demonstrates that there are differences in the demands on players across playing positions in soccer. Training practices in soccer should be based on the specific requirements of each positional role to ensure players can fulfill their tactical responsibilities during the game.
Journal Article
Mapping reviews, scoping reviews, and evidence and gap maps (EGMs): the same but different— the “Big Picture” review family
by
Munn, Zachary
,
Khalil, Hanan
,
Pollock, Danielle
in
Biomedicine
,
Decision making
,
Evidence Gaps
2023
Scoping reviews, mapping reviews, and evidence and gap maps are evidence synthesis methodologies that address broad research questions, aiming to describe a bigger picture rather than address a specific question about intervention effectiveness. They are being increasingly used to support a range of purposes including guiding research priorities and decision making. There is however a confusing array of terminology used to describe these different approaches. In this commentary, we aim to describe where there are differences in terminology and where this equates to differences in meaning. We demonstrate the different theoretical routes that underpin these differences. We suggest ways in which the approaches of scoping and mapping reviews may differ in order to guide consistency in reporting and method. We propose that mapping and scoping reviews and evidence and gap maps have similarities that unite them as a group but also have unique differences. Understanding these similarities and differences is important for informing the development of methods used to undertake and report these types of evidence synthesis.
Journal Article
A scoping review describes methods used to identify, prioritize and display gaps in health research
by
Thu, Van Nguyen
,
Nyanchoka, Linda
,
Porcher, Raphaël
in
Bibliometrics
,
Biomedical Research - standards
,
Biomedical Research - statistics & numerical data
2019
Different methods to examine research gaps have been described, but there are still no standard methods for identifying, prioritizing, or reporting research gaps. This study aimed to describe the methods used to identify, prioritize, and display gaps in health research.
A scoping review using the Arksey and O'Malley methodological framework was carried out. We included all study types describing or reporting on methods to identify, prioritize, and display gaps or priorities in health research. Data synthesis is both quantitative and qualitative.
Among 1,938 identified documents, 139 articles were selected for analysis; 90 (65%) aimed to identify gaps, 23 (17%) aimed to determine research priorities, and 26 (19%) had both aims. The most frequent methods in the review were aimed at gap identification and involved secondary research, which included knowledge synthesis (80/116 articles, 69%), specifically systematic reviews and scoping reviews (58/80, 73%). Among 49 studies aimed at research prioritization, the most frequent methods were both primary and secondary research, accounting for 24 (49%) reports. Finally, 52 (37%) articles described methods for displaying gaps and/or priorities in health research.
This study provides a mapping of different methods used to identify, prioritize, and display gaps or priorities in health research.
Journal Article
GRADE notes: How to use GRADE when there is “no” evidence? A case study of the expert evidence approach
by
Hanson, Sheila
,
Nieuwlaat, Robby
,
Monagle, Paul
in
Case reports
,
Clinical medicine
,
Epidemiology
2021
One essential requirement of trustworthy guidelines is that they should be based on systematic reviews of the best available evidence. The GRADE Working Group has provided guidance for evaluating the certainty of evidence based on several domains. However, for many clinical questions, published evidence may be limited, too indirect or simply not exist. In this brief report (GRADE notes), we describe our method of developing evidence-based recommendations when publisheddirect evidence was lacking.
When direct published literature was absent, an expert evidence survey was administered to panel members about their unpublished observations and case series. Focus was on collecting data about cases and outcome, not panel opinions.
Out of 26 questions prioritized by the panel for pediatric venous thromboembolism, 12 had no, very limited, or very low certainty of evidence to inform them. The panel survey was administered for these questions.
Areas of sparse evidence often reflect key questions that are critical to address in clinical practice guidelines due to the uncertainty among health care providers. The expert evidence approach used in this study is one method for panels totransparently deal with the lack of published evidence to directly inform recommendations.
[Display omitted]
Journal Article