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Is adequate reporting on health equity in systematic review equivalent to an equitable recommendation? A case report

Date and Location

Session: 

P4.004

Date

Monday 23 September 2013 - 10:30 - 12:00

Location

Presenting author and contact person

Presenting author

Chunhu SHI

Contact person

Kehu Yang
Abstract text
Background:Transparently reporting of equity-focused systematic review (SR) is recognized as a contribution to improving the evidence base for evidence-informed, equity-oriented recommendation. Objectives:Aim to discuss whether adequate reporting on health equity in SR is equivalent to a evidence-based, equitable recommendation. Methods:We conducted a case report, basing on a WHO “Guideline: vitamin A supplementation in pregnancy for reducing the risk of mother-to-child transmission of HIV”[1]. The reporting characteristics on health equity of all systematic reviews which are used in guideline are investigated by PRISMA-E 2012 [2]. Then we investigated which factors are considered to formulate recommendations and discussed the relationship between reporting on equity and equitable recommendation in further. Results:Only one Cochrane Review [3] is used by the guideline, which assessed the effects of vitamin A targeted at HIV-positive women. Sexual (sexual health status), place of residence (low- and middle- income coutries) and age (i.e. HIV-positive pregnant women, different children’s age groups) factors are considered in this review. 7 items (i.e. Items 2B, 3A, 6, 6A, 16, 26 and 26A in PRISMA-E 2012 checklist) are not adequately described, especially items on extent and limits of applicability to HIV-positive women, the logic model/analytical framework, a pre-specified subgroup analysis to investigate the differences across age and place of residence factors, etc. According to PROGRESS-Plus framework, only sexual (sexual health status) factor is incorporated to formulate the only recommendation. However, they are lack of recommendations on different age groups and countries, although relevant evidences of synthesizing findings are adequately reported in results section. The main reason maybe no significant effects on the primary outcomes. Conclusions:Although they are summaried and reported in SR, relevant evidences on equity in this case are not used to develop corresponding recommendations, which limit their usage in policy making of health equity where relevant.