A context-specific conceptual framework of evidence synthesis to improve childhood cancer health outcomes and resource use in Egypt: Using real-world data and addressing the implementation gaps

Ranin Soliman
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Abstract

Introduction

Given the large numbers of children with cancer in Egypt, the limited resources, and inferior survival outcomes, there is a need to better target resources to improve outcomes efficiently based on evidence. Nevertheless, there is a gap in knowledge about childhood cancer health outcomes and resource use in Egypt. This commentary presents a “context-specific” conceptual framework of evidence synthesis to improve childhood cancer health outcomes and resource use in a resource-limited setting in Egypt, using real-world data and addressing the implementation gaps.

Methods

Real-world data is defined as data relating to health status and/or the delivery of health services routinely collected from various sources outside the contexts of randomized controlled trials that can be used to conduct prospective/retrospective observational research studies.

Results

To better address this context-specific clinical problem, the conceptual framework of evidence synthesis proposes to generate three types of evidence using hybrid research methods; (1) Real-world evidence (obtained from observational studies based on routinely collected data from local context); (2) systematic evidence from the literature (systematic review); and (3) qualitative evidence based on experts' opinions in the local setting (interview study). Generating evidence from the three pillars altogether makes for a stronger approach to better research and tackle the local problem in this specific resource-limited context, and address the implementation gaps.

Conclusions

This framework serves as a methodological roadmap to generate relevant evidence in similar resource-limited contexts in low- and middle-income countries, where there is a paucity of published studies in the literature about childhood cancer survival outcomes and resource use.

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埃及改善儿童癌症健康结果和资源使用的证据综合的具体背景概念框架:使用现实世界数据并解决实施差距
引言鉴于埃及癌症儿童人数众多,资源有限,生存结果较差,因此需要更好地利用资源,根据证据有效改善结果。尽管如此,埃及在儿童癌症健康结果和资源使用方面的知识仍存在差距。本评论提出了一个证据综合的“特定背景”概念框架,以改善埃及在资源有限的环境中的儿童癌症健康结果和资源使用,使用真实世界的数据并解决实施差距。方法真实世界数据是指在随机对照试验之外,从各种来源常规收集的与健康状况和/或卫生服务提供有关的数据,可用于进行前瞻性/回顾性观察性研究。结果为了更好地解决这一特定背景的临床问题,证据综合的概念框架提出使用混合研究方法生成三种类型的证据;(1) 真实世界的证据(从基于当地常规收集数据的观察性研究中获得);(2) 文献中的系统证据(系统综述);以及(3)基于专家在当地环境中的意见的定性证据(访谈研究)。从这三个支柱中收集证据,有助于采取更有力的方法,在资源有限的特定背景下更好地研究和解决当地问题,并解决实施差距。结论该框架可作为一个方法路线图,在低收入和中等收入国家类似的资源限制背景下生成相关证据,这些国家的文献中很少发表关于儿童癌症生存结果和资源使用的研究。
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