Evidence Synthesis Working Group

The Evidence Synthesis Working Group (ESWG), a collaboration of all nine primary care departments of the SPCR, aims to produce (through the use of novel evidence synthesis methods) high quality reviews that evaluate what works, in what situations, and for whom. The Group also focuses on identifying clinical and methodology gaps to inform future research, policy and develop robust practical interventions for primary care.

Over twenty systematic reviews broadly represent four themes:

Urgent care

Unplanned hospital admissions are a major burden on patients and for UK health services, costing an estimated £12.5 billion annually. The theme explores critical questions such as: Which health and social care interventions help reduce unplanned hospital admissions in older patients? Does advanced care planning (ACP) for older people help to reduce unplanned hospital admissions and improve quality of life?

End-of-Life Care and Bereavement

Bereavement is an important cause of mortality and morbidity especially among older people and those who are socially isolated, influencing both physical and mental health, and the ability to function at work. This theme will use realist synthesis methods to answer the questions: What are the interventions and policies shown to reduce complicated grief in bereaved patients in Primary Care? What are the initiatives that have been employed to improve end of life care in Primary Care?

New drugs and methodologies

The theme provides important evaluative evidence on technologies to improve chronic disease management, and will produce a series of complex systematic reviews that include synthesis of regulatory documents and clinical study reports to evaluate new drugs and some technologies in widespread use, where there is uncertainty about the benefit and harms profiles. An example being the drug Mysimba to treat overweight and obesity.

Service redesign in primary care

The theme aims to answer key questions to support the redesign of future primary care, such as: In what ways and in what contexts does telephone triage impact on workload in primary care, for whom and why? What is the role of care navigators in primary care?

Patient and public involvement and engagement are key components of our work. We recognise that there are many potential benefits to patient and public involvement in systematic reviews, including the consideration and identification of the key outcomes to be assessed. Members of the public have first-hand experience of the disease and treatment, allowing researchers and members of the public to learn from each other to gain a full understanding of a review and its purpose.

Our patient and public involvement strategy involves four core elements: oversight of review conduct and procedure, appropriate involvement in each review, the reporting of involvement and the development of prioritisation partnerships. In addition, the Group will undertake engagement activities to ensure widespread dissemination is carried out. These reviews have direct public relevance and will be disseminated widely in order to ensure their findings reach the public.

In the first phase of our work, we have provided bursaries for early and mid-career researchers to attend Masters level taught courses in evidence synthesis methods. We will also continue to provide short courses in evidence synthesis methods. In addition, we are planning ‘Evidence Synthesis Virtual Clinics’ to provide a research design service for complex evidence synthesis protocols, particularly for early career researchers applying for further funding.