Published on

  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide


  1. 1. Identifying uncertainties: DUETs and the NLH Specialist Libraries Douglas Grindlay University of Nottingham National Library for Health
  2. 2. Scope of talk 1. What is DUETs? 2. Why are the NLH Specialist Libraries in such a good position to compile uncertainties for DUETs? 3. Sources of uncertainties for DUETS, and progress so far…
  3. 3. What is DUETs?
  4. 4. DUETs: • The Database of Uncertainties about the Effects of Treatments • A resource to help prioritise new research • Uncertainties that cannot be answered by reliable, up-to-date systematic reviews
  5. 5. Sources for uncertainties: • Patients’, carers’ and clinicians’ questions about treatment effects • Research recommendations in systematic reviews and clinical guidelines • Ongoing research, both systematic reviews in preparation and new 'primary' studies
  6. 6. Link to the James Lind Alliance: • DUETs set up to help meet aims of the James Lind Alliance (JLA) • JLA brings patients and clinicians together in 'Working Partnerships' to identify and prioritise unanswered research questions
  7. 7. • No relevant systematic reviews identified • Relevant, up-to-date systematic reviews do not address continuing uncertainties • Existing relevant systematic reviews are not up-to-date • Up-to-date systematic reviews have revealed important continuing uncertainties Criteria for DUETS uncertainties:
  8. 8. Why are the NLH Specialist Libraries in such a good position to compile uncertainties for DUETs?
  9. 9. • “One-stop” shop for quality, evidence-based information on skin disorders • Scope: Diagnosis, treatment, management & prevention of skin diseases • Content: Guidelines, systematic reviews, reference resources, CPD, patient information Example: The NLH Skin Disorders Specialist Library
  10. 10. The diversity of 1,000 skin disorders
  11. 11. The NLH Skin Disorders Specialist Library • Based at Centre of Evidence Based Dermatology, University of Nottingham • NHS-funded contract • Close links to Dermatology Department at Queen’s Medical Centre, Nottingham • HE-NHS Crossover!
  12. 12. The Centre of Evidence Based Dermatology
  13. 13. Skin Disorders Library community & stakeholders • Secondary care clinicians – dermatology, plastic surgery, GUM • General Practitioners – GPsWSI, non-specialist GPs • Nurses – Secondary and primary care • Other health professionals – e.g. pharmacists
  14. 14. Skin Disorders Library community & stakeholders (cont.) • Health academics • Health students • Health librarians • Health information specialists • Patients and public • Patient support groups
  15. 15. Communication with our community • Stakeholders Group (formal meetings and individual correspondence) • The Library • Monthly e-mail updates • National Knowledge Weeks • Feedback form • Talks and stand at conferences • Articles
  16. 16. Annual Evidence Updates • Part of National Knowledge Weeks • “Big 50”: acne, atopic eczema, psoriasis, skin cancer • Search for new evidence on a disease topic • Bring together systematic reviews
  17. 17. Implications for DUETs • NLH Specialist Libraries well placed to communicate with their communities of practice • Centre of potential network for collection of uncertainties and research prioritisation • Specialist Libraries are collecting systematic reviews already • Great potential for dissemination
  18. 18. Sources of uncertainties for DUETS, and progress so far…
  19. 19. The DUETS Skin Module Began work in January 2007 • 1st phase – Uncertainties invited from patient groups • 2nd phase – Uncertainties invited from health professionals • 3rd phase – Uncertainties identified from systematic reviews by Skin Disorders Specialist Library team
  20. 20. Uncertainties invited from patient groups • January 2007 – asked National Eczema Society, Psoriasis Association and Acne Support Group for patient questions
  21. 21. Uncertainties invited from patient groups (cont.) • Problem: support groups may lack resources to know if questions = true uncertainties • Needs search for systematic reviews by Specialist Library team to check – a lot of work! • Some rejects, e.g. long-term effects of antibiotics for acne
  22. 22. Uncertainties invited from health professionals • BAD asked to collect uncertainties from their guidelines and Committee meetings – still awaiting results • Contributions from individuals invited in National Knowledge Weeks – no response! • Uncertainties now coming from UK Dermatology Clinical Trials Network
  23. 23. Uncertainties identified from systematic reviews • Currently main focus of work • Tackling one disease at a time to avoid bias in coverage • Started with atopic eczema — 50+ uncertainties identified • Using Cochrane and non- Cochrane reviews • Difficulty in judging uncertainties – often not explicit or clear
  24. 24. Link to National Knowledge Weeks • Annual Evidence Updates involve search for systematic reviews – can be harvested for DUETs • Searches updated annually – update or remove (!) uncertainties as required • Chance to promote DUETs and seek contributions of uncertainties
  25. 25. Future tasks • Acne National Knowledge Week – detailed mapping of systematic reviews by treatment topic • Ideal for compiling DUETs uncertainties • Complete DUETs acne and psoriasis modules • Extend to other skin disorders
  26. 26. Conclusions • Best approach = comprehensive coverage topic by topic • Systematic reviews are easiest source for uncertainties • Uncertainties not always made explicit in systematic reviews • Difficult to mobilise active contributions to DUETs from both individuals and organisations
  27. 27. • DUETs is a work in progress • More modules will come on stream as all the Specialist Libraries become involved • Exciting time—potential of DUETs now being realised • Should influence future research AND patient care Conclusions (cont.)