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Dobolyi K, Sieniawski GP, Dobolyi D, Goldfrank J, Hampel-Arias Z. Hindsight2020: Characterizing Uncertainty in the COVID-19 Scientific Literature. Disaster Med Public Health Prep 2023; 17:e437. [PMID: 37489527 DOI: 10.1017/dmp.2023.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Following emerging, re-emerging, and endemic pathogen outbreaks, the rush to publish and the risk of data misrepresentation, misinterpretation, and even misinformation puts an even greater onus on methodological rigor, which includes revisiting initial assumptions as new evidence becomes available. This study sought to understand how and when early evidence emerges and evolves when addressing different types of recurring pathogen-related questions. By applying claim-matching by means of deep learning Natural Language Processing (NLP) of coronavirus disease 2019 (COVID-19) scientific literature against a set of expert-curated evidence, patterns in timing across different COVID-19 questions-and-answers were identified, to build a framework for characterizing uncertainty in emerging infectious disease (EID) research over time. COVID-19 was chosen as a use case for this framework given the large and accessible datasets curated for scientists during the beginning of the pandemic. Timing patterns in reliably answering broad COVID-19 questions often do not align with general publication patterns, but early expert-curated evidence was generally stable. Because instability in answers often occurred within the first 2 to 6 mo for specific COVID-19 topics, public health officials could apply more conservative policies at the start of future pandemics, to be revised as evidence stabilizes.
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Affiliation(s)
- Kinga Dobolyi
- George Washington University, Department of Computer Science, Washington, DC, USA
| | | | | | - Joseph Goldfrank
- George Washington University, Department of Computer Science, Washington, DC, USA
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2
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Wilmes N, Hendriks CWE, Viets CTA, Cornelissen SJWM, van Mook WNKA, Cox-Brinkman J, Celi LA, Martinez-Martin N, Gichoya JW, Watkins C, Bakhshi-Raiez F, Wynants L, van der Horst ICC, van Bussel BCT. Structural under-reporting of informed consent, data handling and sharing, ethical approval, and application of Open Science principles as proxies for study quality conduct in COVID-19 research: a systematic scoping review. BMJ Glob Health 2023; 8:bmjgh-2023-012007. [PMID: 37257937 DOI: 10.1136/bmjgh-2023-012007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/13/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic required science to provide answers rapidly to combat the outbreak. Hence, the reproducibility and quality of conducting research may have been threatened, particularly regarding privacy and data protection, in varying ways around the globe. The objective was to investigate aspects of reporting informed consent and data handling as proxies for study quality conduct. METHODS A systematic scoping review was performed by searching PubMed and Embase. The search was performed on November 8th, 2020. Studies with hospitalised patients diagnosed with COVID-19 over 18 years old were eligible for inclusion. With a focus on informed consent, data were extracted on the study design, prestudy protocol registration, ethical approval, data anonymisation, data sharing and data transfer as proxies for study quality. For reasons of comparison, data regarding country income level, study location and journal impact factor were also collected. RESULTS 972 studies were included. 21.3% of studies reported informed consent, 42.6% reported waivers of consent, 31.4% did not report consent information and 4.7% mentioned other types of consent. Informed consent reporting was highest in clinical trials (94.6%) and lowest in retrospective cohort studies (15.0%). The reporting of consent versus no consent did not differ significantly by journal impact factor (p=0.159). 16.8% of studies reported a prestudy protocol registration or design. Ethical approval was described in 90.9% of studies. Information on anonymisation was provided in 17.0% of studies. In 257 multicentre studies, 1.2% reported on data sharing agreements, and none reported on Findable, Accessible, Interoperable and Reusable data principles. 1.2% reported on open data. Consent was most often reported in the Middle East (42.4%) and least often in North America (4.7%). Only one report originated from a low-income country. DISCUSSION Informed consent and aspects of data handling and sharing were under-reported in publications concerning COVID-19 and differed between countries, which strains study quality conduct when in dire need of answers.
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Affiliation(s)
- Nick Wilmes
- Deparment of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular research institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Charlotte W E Hendriks
- Deparment of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Caspar T A Viets
- Deparment of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Simon J W M Cornelissen
- Deparment of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Walther N K A van Mook
- Deparment of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Academy for Postgraduate Medical Training, Maastricht University Medical Center, Maastricht, The Netherlands
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Josanne Cox-Brinkman
- Department of Health Law, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Leo A Celi
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Centre, Boston, Massachusetts, USA
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nicole Martinez-Martin
- Department of Pediatrics, Stanford Center for Biomedical Ethics, Stanford University, San Jose, California, USA
| | - Judy W Gichoya
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Emory University, Atlanta, Florida, USA
| | - Craig Watkins
- School of Journalism and Media, University of Texas, Austin, Texas, USA
| | - Ferishta Bakhshi-Raiez
- Department of Medical Informatics, Amsterdam University Medical Centre, Amsterdam and Amsterdam Public Health, Quality of care The Netherlands, Amsterdam, The Netherlands
| | - Laure Wynants
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Iwan C C van der Horst
- Deparment of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular research institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Bas C T van Bussel
- Deparment of Intensive Care Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular research institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Sharp MK, Forde Z, McGeown C, O’Murchu E, Smith SM, O’Neill M, Ryan M, Clyne B. Irish Media Coverage of COVID-19 Evidence-Based Research Reports From One National Agency. Int J Health Policy Manag 2022; 11:2464-2475. [PMID: 35042323 PMCID: PMC9818095 DOI: 10.34172/ijhpm.2021.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/11/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND How research findings are presented through domestic news can influence behaviour and risk perceptions, particularly during emergencies such as the coronavirus disease 2019 (COVID-19) pandemic. Monitoring media communications to track misinformation and find information gaps is an important component of emergency risk communication. Therefore, this study investigated the traditional media coverage of nine selected COVID-19 evidence-based research reports and associated press releases (PRs) published during the initial phases of the pandemic (April to July 2020) by one national agency. METHODS NVivo was used for summative content analysis. 'Key messages' from each research report were proposed and 488 broadcast, print, and online media sources were coded at the phrase level. Manifest content was coded and counted to locate patterns in the data (what and how many) while latent content was analysed to further investigate these patterns (why and how). This included the coding of the presence of political and public health actors in coverage. RESULTS Coverage largely did not misrepresent the results of the reports, however, selective reporting and the variability in the use of quotes from governmental and public health stakeholders changed and contextualised results in different manners than perhaps originally intended in the PR. Reports received varying levels of media attention. Coverage focused on more 'human-interest' stories (eg, spread of COVID-19 by children and excess mortality) as opposed to more technical reports (eg, focusing on viral load, antibodies, testing, etc). CONCLUSION Our findings provide a case-study of European media coverage of evidence reports produced by a national agency. Results highlighted several strengths and weaknesses of current communication efforts.
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Affiliation(s)
- Melissa K. Sharp
- Health Research Board Centre for Primary Care Research, Department of General
Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Zoë Forde
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Cordelia McGeown
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Eamon O’Murchu
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Susan M. Smith
- Health Research Board Centre for Primary Care Research, Department of General
Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Michelle O’Neill
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
| | - Máirín Ryan
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
- Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity
Health Sciences, Dublin 8, Ireland
| | - Barbara Clyne
- Health Research Board Centre for Primary Care Research, Department of General
Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Health Information and Quality Authority, George’s Court, George’s Lane, Dublin
7, Ireland
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Lewis A. Strengths and Weaknesses of the Research Enterprise During the Pandemic. J Neuroophthalmol 2022; 42:11-17. [PMID: 35500235 DOI: 10.1097/wno.0000000000001466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ariane Lewis
- Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, New York, New York
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Haber NA, Clarke-Deelder E, Feller A, Smith ER, Salomon JA, MacCormack-Gelles B, Stone EM, Bolster-Foucault C, Daw JR, Hatfield LA, Fry CE, Boyer CB, Ben-Michael E, Joyce CM, Linas BS, Schmid I, Au EH, Wieten SE, Jarrett B, Axfors C, Nguyen VT, Griffin BA, Bilinski A, Stuart EA. Problems with evidence assessment in COVID-19 health policy impact evaluation: a systematic review of study design and evidence strength. BMJ Open 2022; 12:e053820. [PMID: 35017250 PMCID: PMC8753111 DOI: 10.1136/bmjopen-2021-053820] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/03/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Assessing the impact of COVID-19 policy is critical for informing future policies. However, there are concerns about the overall strength of COVID-19 impact evaluation studies given the circumstances for evaluation and concerns about the publication environment. METHODS We included studies that were primarily designed to estimate the quantitative impact of one or more implemented COVID-19 policies on direct SARS-CoV-2 and COVID-19 outcomes. After searching PubMed for peer-reviewed articles published on 26 November 2020 or earlier and screening, all studies were reviewed by three reviewers first independently and then to consensus. The review tool was based on previously developed and released review guidance for COVID-19 policy impact evaluation. RESULTS After 102 articles were identified as potentially meeting inclusion criteria, we identified 36 published articles that evaluated the quantitative impact of COVID-19 policies on direct COVID-19 outcomes. Nine studies were set aside because the study design was considered inappropriate for COVID-19 policy impact evaluation (n=8 pre/post; n=1 cross-sectional), and 27 articles were given a full consensus assessment. 20/27 met criteria for graphical display of data, 5/27 for functional form, 19/27 for timing between policy implementation and impact, and only 3/27 for concurrent changes to the outcomes. Only 4/27 were rated as overall appropriate. Including the 9 studies set aside, reviewers found that only four of the 36 identified published and peer-reviewed health policy impact evaluation studies passed a set of key design checks for identifying the causal impact of policies on COVID-19 outcomes. DISCUSSION The reviewed literature directly evaluating the impact of COVID-19 policies largely failed to meet key design criteria for inference of sufficient rigour to be actionable by policy-makers. More reliable evidence review is needed to both identify and produce policy-actionable evidence, alongside the recognition that actionable evidence is often unlikely to be feasible.
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Affiliation(s)
- Noah A Haber
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | - Emma Clarke-Deelder
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Avi Feller
- Department of Statistics, Goldman School of Public Policy, University of California Berkeley, Berkeley, California, USA
| | - Emily R Smith
- Department of Global Health, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA
| | - Joshua A Salomon
- Department of Health Policy, Stanford University, Stanford, CA, USA
| | - Benjamin MacCormack-Gelles
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth M Stone
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Clara Bolster-Foucault
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Jamie R Daw
- Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Laura Anne Hatfield
- Department of Biostatistics, Harvard Medical School, Boston, Massachusetts, USA
| | - Carrie E Fry
- Department of Health Policy, Vanderbilt University, Nashville, Tennessee, USA
| | - Christopher B Boyer
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Eli Ben-Michael
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Caroline M Joyce
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Beth S Linas
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Applied Public Health and Research, RTI International, Washington, DC, USA
| | - Ian Schmid
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eric H Au
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah E Wieten
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | - Brooke Jarrett
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cathrine Axfors
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | - Van Thu Nguyen
- Meta Research Innovation Center at Stanford University (METRICS), Stanford University, Stanford, California, USA
| | | | - Alyssa Bilinski
- Interfaculty Initiative in Health Policy, Harvard University Graduate School of Arts and Sciences, Cambridge, Massachusetts, USA
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Venturelli A, Vitolo M, Albini A, Boriani G. How did COVID-19 affect medical and cardiology journals? A pandemic in literature. J Cardiovasc Med (Hagerstown) 2021; 22:840-847. [PMID: 34482327 PMCID: PMC10100635 DOI: 10.2459/jcm.0000000000001245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/28/2021] [Accepted: 08/03/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS The spreading speed of the COVID-19 pandemic forced the medical community to produce efforts in updating and sharing the evidence about this new disease, trying to preserve the accuracy of the data but at the same time avoiding the potentially harmful delay from discovery to implementation. The aim of our analysis was to assess the impact of the COVID-19 pandemic on medical literature in terms of proportion of COVID-19-related published papers and temporal patterns of publications within a sample of general/internal medicine and cardiology journals. METHODS We searched through PubMed scientific papers published from 1 January 2020 to 31 January 2021 about COVID-19 in ten major medical journals, of which five were in general/internal medicine and five in the cardiology field. We analyzed the proportion of COVID-19-related papers, and we examined temporal trends in the number of published papers. RESULTS Overall, the proportion of COVID-19-related papers was 18.5% (1986/10 756). This proportion was higher among the five selected general/internal medicine journals, compared with cardiology journals (23.8% vs 9.5%). The vast majority of papers were not original articles; in particular, in cardiology journals, there were 28% 'original articles', 17% 'review articles' and 55.1% 'miscellaneous', compared with 20.2%, 5.1% and 74.7% in general/internal medicine journals, respectively. CONCLUSIONS Our analysis highlights the big impact of the COVID-19 pandemic on international scientific literature. General and internal medicine journals were mainly involved, with cardiology journals only at a later time.
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Affiliation(s)
- Andrea Venturelli
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Albini
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
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Jesus-Silva SGD, Antonio ACP. Research integrity in times of pandemic. REVISTA CIÊNCIAS EM SAÚDE 2021. [DOI: 10.21876/rcshci.v11i3.1220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In 1994, Douglas Graham Altman, one of the greatest statisticians of all time, wrote "We need less research, better research, and research done for good reasons". Twenty-seven years ago, Altman pointed out that the system favored unscientific behavior and that "bad science" was easy to publish, highlighting the financial implications of this amount of poorly designed research, with erroneous statistical methods, unrepresentative samples, or fraud. The covid-19 pandemic has once again put clinical research in check. The pressure for urgent responses was unprecedented. Knowledge of the origin of the virus, the transmission dynamics, the pathophysiology of the disease, efficient pharmacological and non-pharmacological measures would be counted in lives - and economies, and in governments.
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Khatter A, Naughton M, Dambha-Miller H, Redmond P. Is rapid scientific publication also high quality? Bibliometric analysis of highly disseminated COVID-19 research papers. LEARNED PUBLISHING 2021; 34:568-577. [PMID: 34226800 PMCID: PMC8242915 DOI: 10.1002/leap.1403] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/25/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022]
Abstract
The impact of COVID-19 has underlined the need for reliable information to guide clinical practice and policy. This urgency has to be balanced against disruption to journal handling capacity and the continued need to ensure scientific rigour. We examined the reporting quality of highly disseminated COVID-19 research papers using a bibliometric analysis examining reporting quality and risk of bias (RoB) amongst 250 top scoring Altmetric Attention Score (AAS) COVID-19 research papers between January and April 2020. Method-specific RoB tools were used to assess quality. After exclusions, 84 studies from 44 journals were included. Forty-three (51%) were case series/studies, and only one was an randomized controlled trial. Most authors were from institutions based in China (n = 44, 52%). The median AAS and impact factor was 2015 (interquartile range [IQR] 1,105-4,051.5) and 12.8 (IQR 5-44.2) respectively. Nine studies (11%) utilized a formal reporting framework, 62 (74%) included a funding statement, and 41 (49%) were at high RoB. This review of the most widely disseminated COVID-19 studies highlights a preponderance of low-quality case series with few research papers adhering to good standards of reporting. It emphasizes the need for cautious interpretation of research and the increasingly vital responsibility that journals have in ensuring high-quality publications.
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Affiliation(s)
- Amandeep Khatter
- School of Population Health and Environmental Sciences King's College London London UK
| | - Michael Naughton
- School of Population Health and Environmental Sciences King's College London London UK
| | - Hajira Dambha-Miller
- School of Primary Care Population Sciences and Medical Education (PPM) University of Southampton UK
| | - Patrick Redmond
- School of Population Health and Environmental Sciences King's College London London UK.,Department of General Practice Royal College of Surgeons in Ireland Dublin Ireland
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9
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Haber NA, Clarke-Deelder E, Feller A, Smith ER, Salomon J, MacCormack-Gelles B, Stone EM, Bolster-Foucault C, Daw JR, Hatfield LA, Fry CE, Boyer CB, Ben-Michael E, Joyce CM, Linas BS, Schmid I, Au EH, Wieten SE, Jarrett BA, Axfors C, Nguyen VT, Griffin BA, Bilinski A, Stuart EA. Problems with Evidence Assessment in COVID-19 Health Policy Impact Evaluation (PEACHPIE): A systematic review of study design and evidence strength. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 33501457 PMCID: PMC7836129 DOI: 10.1101/2021.01.21.21250243] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Assessing the impact of COVID-19 policy is critical for informing future policies. However, there are concerns about the overall strength of COVID-19 impact evaluation studies given the circumstances for evaluation and concerns about the publication environment. This study systematically reviewed the strength of evidence in the published COVID-19 policy impact evaluation literature. Methods: We included studies that were primarily designed to estimate the quantitative impact of one or more implemented COVID-19 policies on direct SARS-CoV-2 and COVID-19 outcomes. After searching PubMed for peer-reviewed articles published on November 26, 2020 or earlier and screening, all studies were reviewed by three reviewers first independently and then to consensus. The review tool was based on previously developed and released review guidance for COVID-19 policy impact evaluation, assessing what impact evaluation method was used, graphical display of outcomes data, functional form for the outcomes, timing between policy and impact, concurrent changes to the outcomes, and an overall rating. Results: After 102 articles were identified as potentially meeting inclusion criteria, we identified 36 published articles that evaluated the quantitative impact of COVID-19 policies on direct COVID-19 outcomes. The majority (n=23/36) of studies in our sample examined the impact of stay-at-home requirements. Nine studies were set aside because the study design was considered inappropriate for COVID-19 policy impact evaluation (n=8 pre/post; n=1 cross-section), and 27 articles were given a full consensus assessment. 20/27 met criteria for graphical display of data, 5/27 for functional form, 19/27 for timing between policy implementation and impact, and only 3/27 for concurrent changes to the outcomes. Only 1/27 studies passed all of the above checks, and 4/27 were rated as overall appropriate. Including the 9 studies set aside, reviewers found that only four of the 36 identified published and peer-reviewed health policy impact evaluation studies passed a set of key design checks for identifying the causal impact of policies on COVID-19 outcomes. Discussion: The reviewed literature directly evaluating the impact of COVID-19 policies largely failed to meet key design criteria for inference of sufficient rigor to be actionable by policymakers. This was largely driven by the circumstances under which policies were passed making it difficult to attribute changes in COVID-19 outcomes to particular policies. More reliable evidence review is needed to both identify and produce policy-actionable evidence, alongside the recognition that actionable evidence is often unlikely to be feasible.
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Affiliation(s)
- Noah A Haber
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Emma Clarke-Deelder
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Avi Feller
- Goldman School of Public Policy, UC Berkeley, Berkeley, CA, USA
| | - Emily R Smith
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, D.C, USA
| | - Joshua Salomon
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA
| | | | - Elizabeth M Stone
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Clara Bolster-Foucault
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Jamie R Daw
- Health Policy and Management, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Laura A Hatfield
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Carrie E Fry
- Department of Health Policy, Vanderbilt University, Nashville, TN, USA
| | - Christopher B Boyer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eli Ben-Michael
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Caroline M Joyce
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Beth S Linas
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Clinical Quality and Informatics, MITRE Corp, McLean, VA, USA
| | - Ian Schmid
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eric H Au
- School of Public Health, University of Sydney, Sydney, Australia
| | - Sarah E Wieten
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Brooke A Jarrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cathrine Axfors
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Van Thu Nguyen
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | | | - Alyssa Bilinski
- Interfaculty Initiative in Health Policy, Harvard Graduate School of Arts and Sciences, Cambridge, MA, USA
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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