Publications by category
Journal articles
Coon JT, Orr N, Shaw L, Hunt H, Garside R, Nunns M, Gröppel-Wegener A, Whear B (2022). Bursting out of our bubble: using creative techniques to communicate within the systematic review process and beyond.
Systematic Reviews,
11(1).
Abstract:
Bursting out of our bubble: using creative techniques to communicate within the systematic review process and beyond
Abstract
. Background
. Increasing pressure to publicise research findings and generate impact, alongside an expectation from funding bodies to go beyond publication within academic journals, has generated interest in alternative methods of science communication.
. Our aim is to describe our experience of using a variety of creative communication tools, reflect on their use in different situations, enhance learning and generate discussion within the systematic review community.
.
. Methods
. Over the last 5 years, we have explored several creative communication tools within the systematic review process and beyond to extend dissemination beyond traditional academic mechanisms.
. Central to our approach is the co-production of a communication plan with potential evidence users which facilitates (i) the identification of key messages for different audiences, (ii) discussion of appropriate tools to communicate key messages and (iii) exploration of avenues to share them. We aim to involve evidence users in the production of a variety of outputs for each research project cognisant of the many ways in which individuals engage with information.
.
. Results
. Our experience has allowed us to develop an understanding of the benefits and challenges of a wide range of creative communication tools. For example, board games can be a fun way of learning, may flatten power hierarchies between researchers and research users and enable sharing of large amounts of complex information in a thought provoking way, but they are time and resource intensive both to produce and to engage with. Conversely, social media shareable content can be quick and easy to produce and to engage with but limited in the depth and complexity of shareable information.
.
. Discussion
. It is widely recognised that most stakeholders do not have time to invest in reading large, complex documents; creative communication tools can be a used to improve accessibility of key messages. Furthermore, our experience has highlighted a range of additional benefits of embedding these techniques within our project processes e.g. opening up two-way conversations with end-users of research to discuss the implications of findings.
.
Abstract.
Sugg HVR, Richards DA, Russell A, Burnett S, Cockcroft EJ, Thompson Coon J, Cruickshank S, Doris FE, Hunt HA, Iles‐Smith H, et al (2022). Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with <scp>COVID</scp>‐19 caused by infection with the <scp>SARS‐COV</scp>‐2 virus: Results from the ‘<scp>COVID‐NURSE</scp>’ survey.
Journal of Advanced Nursing,
79(3), 1003-1017.
Abstract:
Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID‐19 caused by infection with the SARS‐COV‐2 virus: Results from the ‘COVID‐NURSE’ survey
AbstractAimsTo identify strategies used by registered nurses and non‐registered nursing care staff in overcoming barriers when providing fundamental nursing care for non‐invasively ventilated inpatients with COVID‐19.DesignOnline survey with open‐ended questions to collect qualitative data.MethodsIn August 2020, we asked UK‐based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non‐invasively ventilated patients with COVID‐19. We analysed data using Framework Analysis.ResultsA total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non‐verbal communication with patients, using information technology to enable patients’ significant others to communicate with staff and patients, and establishing clear information‐sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self‐care and using ‘runners’ and interdisciplinary input. 3) Addressing patients’ well‐being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients’ wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks.ConclusionsOur respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well‐being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing.ImpactAs these strategies are unlikely to be exclusive to the COVID‐19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.
Abstract.
Richards DA, Sugg HVR, Cockcroft E, Cooper J, Cruickshank S, Doris F, Hulme C, Logan P, Iles-Smith H, Melendez-Torres GJ, et al (2021). COVID-NURSE: evaluation of a fundamental nursing care protocol compared with care as usual on experience of care for noninvasively ventilated patients in hospital with the SARS-CoV-2 virus—protocol for a cluster randomised controlled trial.
BMJ Open,
11(5), e046436-e046436.
Abstract:
COVID-NURSE: evaluation of a fundamental nursing care protocol compared with care as usual on experience of care for noninvasively ventilated patients in hospital with the SARS-CoV-2 virus—protocol for a cluster randomised controlled trial
IntroductionPatient experience of nursing care is correlated with safety, clinical effectiveness, care quality, treatment outcomes and service use. Effective nursing care includes actions to develop nurse–patient relationships and deliver physical and psychosocial care to patients. The high risk of transmission of the SARS-CoV-2 virus compromises nursing care. No evidence-based nursing guidelines exist for patients infected with SARS-CoV-2, leading to potential variations in patient experience, outcomes, quality and costs.Methods and analysiswe aim to recruit 840 in-patient participants treated for infection with the SARS-CoV-2 virus from 14 UK hospitals, to a cluster randomised controlled trial, with embedded process and economic evaluations, of care as usual and a fundamental nursing care protocol addressing specific areas of physical, relational and psychosocial nursing care where potential variation may occur, compared with care as usual. Our coprimary outcomes are patient-reported experience (Quality from the Patients’ Perspective; Relational Aspects of Care Questionnaire); secondary outcomes include care quality (pressure injuries, falls, medication errors); functional ability (Barthell Index); treatment outcomes (WHO Clinical Progression Scale); depression Patient Health Questionnaire-2 (PHQ-2), anxiety General Anxiety Disorder-2 (GAD-2), health utility (EQ5D) and nurse-reported outcomes (Measure of Moral Distress for Health Care Professionals). For our primary analysis, we will use a standard generalised linear mixed-effect model adjusting for ethnicity of the patient sample and research intensity at cluster level. We will also undertake a planned subgroup analysis to compare the impact of patient-level ethnicity on our primary and secondary outcomes and will undertake process and economic evaluations.Ethics and disseminationResearch governance and ethical approvals are from the UK National Health Service Health Research Authority Research Ethics Service. Dissemination will be open access through peer-reviewed scientific journals, study website, press and online media, including free online training materials on the Open University’s FutureLearn web platform.Trial registration numberISRCTN13177364; Pre-results.
Abstract.
Sugg HVR, Russell A-M, Morgan L, Iles-Smith H, Richards DA, Morley N, Burnett S, Cockcroft E, Thompson Coon J, Cruickshank S, et al (2021). Fundamental nursing care in patients with the SARS-CoV-2 virus: results from the ‘COVID-NURSE’ mixed methods survey into nurses’ experiences of missed care and barriers to care. BMC Nursing, 20
Eke H, Hunt H, Ball S, Rogers M, Whear R, Allinson A, Melluish J, Lindsay C, Richardson D, Rogers J, et al (2021). Improving continence in children and young people with neurodisability: survey of current NHS practice and systematic review of effectiveness, cost-effectiveness and contextual factors that modify implementation of interventions. Health Technology Assessment
Cohen JF, Deeks JJ, Hooft L, Salameh J-P, Korevaar DA, Gatsonis C, Hopewell S, Hunt HA, Hyde CJ, Leeflang MM, et al (2021). Preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts): checklist, explanation, and elaboration.
BMJ,
372Abstract:
Preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts): checklist, explanation, and elaboration.
For many users of the biomedical literature, abstracts may be the only source of information about a study. Hence, abstracts should allow readers to evaluate the objectives, key design features, and main results of the study. Several evaluations have shown deficiencies in the reporting of journal and conference abstracts across study designs and research fields, including systematic reviews of diagnostic test accuracy studies. Incomplete reporting compromises the value of research to key stakeholders. The authors of this article have developed a 12 item checklist of preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts). This article presents the checklist, examples of complete reporting, and explanations for each item of PRISMA-DTA for Abstracts.
Abstract.
Author URL.
Salameh JP, Bossuyt PM, McGrath TA, Thombs BD, Hyde CJ, MacAskill P, Deeks JJ, Leeflang M, Korevaar DA, Whiting P, et al (2020). Preferred reporting items for systematic review and meta-analysis of diagnostic test accuracy studies (PRISMA-DTA): Explanation, elaboration, and checklist.
The BMJ,
370(12).
Abstract:
Preferred reporting items for systematic review and meta-analysis of diagnostic test accuracy studies (PRISMA-DTA): Explanation, elaboration, and checklist
Systematic reviews of diagnostic test accuracy (DTA) studies are fundamental to the decision making process in evidence based medicine. Although such studies are regarded as high level evidence, these reviews are not always reported completely and transparently. Suboptimal reporting of DTA systematic reviews compromises their validity and generalisability, and subsequently their value to key stakeholders. An extension of the PRISMA (preferred reporting items for systematic review and meta-analysis) statement was recently developed to improve the reporting quality of DTA systematic reviews. The PRISMA-DTA statement has 27 items, of which eight are unmodified from the original PRISMA statement. This article provides an explanation for the 19 new and modified items, along with their meaning and rationale. Examples of complete reporting are used for each item to illustrate best practices.
Abstract.
McCartney M, Fell G, Finnikin S, Hunt H, McHugh M, Gray M (2020). Why 'case finding' is bad science.
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE,
113(2), 54-58.
Author URL.
Olsen M, Zhelev Z, Hunt H, Peters JL, Bossuyt P, Hyde C (2019). Use of test accuracy study design labels in NICE's diagnostic guidance.
Diagn Progn Res,
3Abstract:
Use of test accuracy study design labels in NICE's diagnostic guidance.
BACKGROUND: a variety of study designs are available to evaluate the accuracy of tests, but the terms used to describe these designs seem to lack clarity and standardization. We investigated if this was the case in the diagnostic guidance of the National Institute of Care and Health Excellence (NICE), an influential source of advice on the value of tests. OBJECTIVES: to describe the range of study design terms and labels used to distinguish study designs in NICE Diagnostic Guidance and the underlying evidence reports. METHODS: We carefully examined all NICE Diagnostic Guidance that has been developed from inception in 2011 until 2018 and the corresponding diagnostic assessment reports that summarized the evidence, focusing on guidance where tests were considered for diagnosis. We abstracted labels used to describe study designs and investigated what labels were used when studies were weighted differently because of their design (in terms of validity of evidence), in relevant sections. We made a descriptive analysis to assess the range of labels and also categorized labels by design features. RESULTS: from a total of 36 pieces of guidance, 20 (56%) were eligible and 17 (47%) were included in our analysis. We identified 53 unique design labels, of which 19 (36%) were specific to diagnostic test accuracy designs. These referred to a total of 12 study design features. Labels were used in assigning different weights to studies in seven of the reports (41%) but never in the guidance documents. CONCLUSION: Our study confirms a lack of clarity and standardization of test accuracy study design terms. There seems to be scope to reduce and harmonize the number of terms and still capture the design features that were deemed influential by those compiling the evidence reports. This should help decision makers in quickly identifying subgroups of included studies that should be weighted differently because their designs are more susceptible to bias.
Abstract.
Author URL.
Hunt H, Abbott R, Boddy K, Whear R, Wakely L, Bethel A, Morris C, Prosser S, Collinson A, Kurinczuk J, et al (2019). “They've walked the walk”: a systematic review of quantitative and qualitative evidence for parent-to-parent support for parents of babies in neonatal care.
Journal of Neonatal Nursing,
25(4), 166-176.
Abstract:
“They've walked the walk”: a systematic review of quantitative and qualitative evidence for parent-to-parent support for parents of babies in neonatal care
The aim of this systematic review was to explore the effects and experiences of parent-to-parent support in neonatal intensive care from the perspectives of those giving, receiving, or implementing support. Electronic database searches (14 databases; February 2018) were supplemented with forward and backward citation chasing. Study selection, data extraction and quality appraisal were performed independently by two reviewers. Fourteen studies (6 quantitative and 8 qualitative) met our inclusion criteria. Four major themes were identified in the qualitative literature: ‘trust’, ‘hope’, ‘information’, and ‘connecting’. Quantitative studies showed parent-to-parent support increased perceptions of support, reduced maternal stress, and increased mothers' confidence in the ability to care for their baby. Whilst the rich qualitative evidence suggested mostly positive experiences of parent-to-parent support from all perspectives, robust trial evidence was lacking. Furthermore, differences in models for implementing parent-to-parent support provided limited opportunities to develop recommendations to guide best practice. The protocol for this study was registered on PROSPERO, registration number CRD42018090569.
Abstract.
Hunt H, Pollock A, Campbell P, Estcourt L, Brunton G (2018). An introduction to overviews of reviews: planning a relevant research question and objective for an overview.
Syst Rev,
7(1).
Abstract:
An introduction to overviews of reviews: planning a relevant research question and objective for an overview.
BACKGROUND: Overviews of systematic reviews are a relatively new approach to synthesising evidence, and research methods and associated guidance are developing. Within this paper we aim to help readers understand key issues which are essential to consider when taking the first steps in planning an overview. These issues relate to the development of clear, relevant research questions and objectives prior to the development of an overview protocol. METHODS: Initial discussions and key concepts for this paper were formed during a workshop on overview methods at the 2016 UK Cochrane Symposium, at which all members of this author group presented work and contributed to wider discussions. Detailed descriptions of the various key features of overviews and their different objectives were created by the author group based upon current evidence (Higgins J, Green S. Cochrane Handbook Syst Rev Interv. 2011;4:5, Pollock M, et al. Sys Rev. 2016;5:190-205, Pollock A, et al. Cochrane overviews of reviews: exploring the methods and challenges. UK and Ireland: Cochrane Symposium; 2016, Pieper D, et al. Res Syn Meth. 2014;5:187-99, Lunny C, et al. Sys Rev. 2016;5:4-12, Hartling L, et al. Comparing multiple treatments: an introduction to overviews of reviews. In 23rd Cochrane Colloquium; 2015, Hartling L, et al. Plos One. 2012;7:1-8, Ballard M, Montgomery P. Res Syn Meth. 2017;8:92-108) and author experiences conducting overviews. RESULTS: Within this paper we introduce different types of overviews and suggest common research questions addressed by these overviews. We briefly reflect on the key features and objectives of the example overviews discussed. CONCLUSIONS: Clear decisions relating to the research questions and objectives are a fundamental first step during the initial planning stages for an overview. Key stakeholders should be involved at the earliest opportunity to ensure that the planned overview is relevant and meaningful to the potential end users of the overview. Following best practice in common with other forms of systematic evidence synthesis, an overview protocol should be published, ensuring transparency and reducing opportunities for introduction of bias in the conduct of the overview.
Abstract.
Author URL.
Hunt H, Whear R, Boddy K, Wakely L, Bethel A, Morris C, Abbott R, Prosser S, Collinson A, Kurinczuk J, et al (2018). Parent-to-parent support interventions for parents of babies cared for in a neonatal unit-protocol of a systematic review of qualitative and quantitative evidence.
Syst Rev,
7(1).
Abstract:
Parent-to-parent support interventions for parents of babies cared for in a neonatal unit-protocol of a systematic review of qualitative and quantitative evidence.
BACKGROUND: Parents of babies admitted to neonatal units experience an arduous emotional journey. Feelings of helplessness, fear, sadness, guilt, grief and anger are common. These feelings can lead to anxiety, depression and post-traumatic stress which may persist long after discharge from the unit. Support from a parent with first-hand experience able to empathise with problems and challenges may help. This systematic review will identify quantitative and qualitative evidence to address the role of parent-to-parent support interventions for families of babies cared for in neonatal units, and combine the findings in an integrated synthesis. METHODS: We are working in collaboration with a study-specific Parent Advisory Group (PAG) of parents who have relevant and varied lived experience of having a baby in neonatal care and those who have been involved in providing peer support. With the PAG, we will carry out a systematic review bringing together all existing research on parent-to-parent support for parents of babies cared for in neonatal units. This will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol extension (PRISMA-P). We have co-produced a plain language protocol summary with the PAG which details the different stages of the project, and this is available via our website ( http://clahrc-peninsula.nihr.ac.uk/research/parent-to-parent-support ) for anyone interested in learning more about the detail of the project. DISCUSSION: all outputs will be available on the NIHR CLAHRC South West Peninsula (PenCLAHRC) website and promoted via PenCLAHRC networks as well as organisations that have been contacted throughout the project. PAG members will be involved in writing and reviewing the academic paper and final report and in co-producing dissemination products such as plain language summaries. The PAG will influence the main conclusions of the systematic review, aid interpretation and help to communicate results in the most appropriate ways. We will hold an impact conference with representatives from neonatal units, national neonatal networks, commissioners of services and parents to discuss what the findings mean for clinical practice and service provision. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018090569.
Abstract.
Author URL.
McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, Cohen JF, Deeks JJ, Gatsonis C, Hooft L, et al (2018). Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies the PRISMA-DTA Statement.
JAMA - Journal of the American Medical Association,
319(4), 388-396.
Abstract:
Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies the PRISMA-DTA Statement
IMPORTANCE Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. OBJECTIVE to develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. DESIGN Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. FINDINGS the systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. CONCLUSIONS AND RELEVANCE the 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.
Abstract.
Pollock A, Campbell P, Brunton G, Hunt HA, Estcourt L (2017). Selecting and implementing overview methods: implications from five exemplar overviews.
Systematic Reviews,
6(1), 145-163.
Abstract:
Selecting and implementing overview methods: implications from five exemplar overviews
Background
Overviews of systematic reviews are an increasingly popular method of evidence synthesis; there is a lack of clear guidance for completing overviews and a number of methodological challenges. At the UK Cochrane Symposium 2016, methodological challenges of five overviews were explored. Using data from these five overviews, practical implications to support methodological decision making of authors writing protocols for future overviews are proposed.
Methods
Methods, and their justification, from the five exemplar overviews were tabulated and compared with areas of debate identified within current literature. Key methodological challenges and implications for development of overview protocols were generated and synthesised into a list, discussed and refined until there was consensus.
Results
Methodological features of three Cochrane overviews, one overview of diagnostic test accuracy and one mixed methods overview have been summarised. Methods of selection of reviews and data extraction were similar. Either the AMSTAR or ROBIS tool was used to assess quality of included reviews. The GRADE approach was most commonly used to assess quality of evidence within the reviews.
Eight key methodological challenges were identified from the exemplar overviews. There was good agreement between our findings and emerging areas of debate within a recent published synthesis. Implications for development of protocols for future overviews were identified.
Conclusions
Overviews are a relatively new methodological innovation, and there are currently substantial variations in the methodological approaches used within different overviews. There are considerable methodological challenges for which optimal solutions are not necessarily yet known. Lessons learnt from five exemplar overviews highlight a number of methodological decisions which may be beneficial to consider during the development of an overview protocol.
Abstract.
Hunt HA, Van Kampen S, Takwoingi Y, Llewellyn DJ, Pearson M, Hyde CJ (2017). The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: a systematic review protocol. Diagnostic and Prognostic Research, 1, 1-6.
Pearson M, Hunt HA, Cooper C, Shepperd S, Pawson R, Anderson R (2015). Providing effective and preferred care closer to home: a realist review of intermediate care. Health and Social Care in the Community, 2(23).
Hunt HA, Stanworth S, Curry N, Wolley T, Cooper C, Ukoumunne O, Zhelev Z, Hyde C (2015). Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding. Cochrane Database of Systematic Reviews 2015(2).
Hunt HA, Hyde CJ, Stanworth S, Curry N, Perel P, Woolley T, Cooper C, Ukoumunne O (2013). Thromboelastography (TEG) and thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding [Protocol]. Cochrane Database of Systematic Reviews 2013
Pearson M, Hunt H, Garside R, Moxham T, Peters J, Anderson R (2012). Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs.
Inj Prev,
18(2), 113-123.
Abstract:
Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs.
INTRODUCTION: Unintentional injuries to children in the outdoors have a significant impact on child mortality, development and healthcare costs. This paper presents the findings of a systematic review about the effectiveness of programs that provided information, advice or education about the prevention of unintentional injuries to children under 15 years during outdoor play and leisure. METHODS: a structured search strategy was conducted in a range of databases. All report titles and abstracts were screened using pre-defined criteria. Included reports were quality appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) tool. All quality appraisals and data extraction were checked by a second reviewer. If not provided in the original reports, ORs and mean differences were calculated, where sufficient data were available. RESULTS: Twenty-three studies met the inclusion criteria. There was a paucity of robust study designs. The majority of studies only reported a short-term follow-up of intermediate outcome measures. Only two studies measured injury rates; both reported a reduction, but both studies also had considerable methodological weaknesses. The five studies that measured the use of protective equipment reported mixed results, although there is some evidence that suggests that more extensive educational programs (such as health fairs and media campaigns) increase their use. The 20 studies that measured behaviour, attitude or knowledge outcomes reported highly mixed results. DISCUSSION: Methodological weaknesses of the included studies limit support for a particular course of action. To better inform policy and practice, future research should (1) use robust study designs and (2) not rely on short-term proxy outcome measures.
Abstract.
Author URL.
Peason MN, Hunt HA, Garside R, Moxham T, Peters J, Anderson R (2011). Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs.
Inj Prev,
2(18).
Abstract:
Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs
INTRODUCTION:
Unintentional injuries to children in the outdoors have a significant impact on child mortality, development and healthcare costs. This paper presents the findings of a systematic review about the effectiveness of programs that provided information, advice or education about the prevention of unintentional injuries to children under 15 years during outdoor play and leisure.
METHODS:
A structured search strategy was conducted in a range of databases. All report titles and abstracts were screened using pre-defined criteria. Included reports were quality appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) tool. All quality appraisals and data extraction were checked by a second reviewer. If not provided in the original reports, ORs and mean differences were calculated, where sufficient data were available.
RESULTS:
Twenty-three studies met the inclusion criteria. There was a paucity of robust study designs. The majority of studies only reported a short-term follow-up of intermediate outcome measures. Only two studies measured injury rates; both reported a reduction, but both studies also had considerable methodological weaknesses. The five studies that measured the use of protective equipment reported mixed results, although there is some evidence that suggests that more extensive educational programs (such as health fairs and media campaigns) increase their use. The 20 studies that measured behaviour, attitude or knowledge outcomes reported highly mixed results.
DISCUSSION:
Methodological weaknesses of the included studies limit support for a particular course of action. To better inform policy and practice, future research should (1) use robust study designs and (2) not rely on short-term proxy outcome measures.
Abstract.
Author URL.
Conferences
Hunt HA, Hyde CJ (2017). An overview of systematic reviews summarising the accuracy of brief cognitive assessments for identifying dementia in primary care. Methods for Evaluating Medical Tests and Biomarkers. 19th - 20th Jul 2016.
Abstract:
An overview of systematic reviews summarising the accuracy of brief cognitive assessments for identifying dementia in primary care
Abstract.
Hunt HA (2017). Testing times for dementia: How long do brief cognitive assessments actually take to carry out?. University of Exeter Academic Research Event. 11th - 12th May 2017.
Abstract:
Testing times for dementia: How long do brief cognitive assessments actually take to carry out?
Abstract.
Lourida I, Kuzma E, Ranson JM, Hunt H, Talens‐Bou J, Rogers M, Thompson‐Coon J, Llewellyn DJ (2017). [P2–094]: DEVELOPMENT OF a DEMENTIA META‐EVIDENCE DATABASE (EMANATE).
Hunt HA (2016). Cochrane overviews of reviews: exploring the methods and challenges. An overview of systematic reviews of diagnostic test accuracy (workshop). Cochrane UK & Ireland Symposium 2016: Impact, Innovation and Ingenuity. 15th - 16th Mar 2016.
Hunt HA (2016). How can primary care support a more effective route to dementia diagnosis?. University of Exeter Medical School Academic Research Event. 18th - 20th May 2016.
Abstract:
How can primary care support a more effective route to dementia diagnosis?
Abstract.
Hunt HA, Hyde CJ (2016). Overview (de)generation: a. review of reviews on the. diagnostic accuracy of. brief cognitive assessments for identifying dementia in primary care. 24th Cochrane Colloquium. 23rd - 27th Oct 2016.
Abstract:
Overview (de)generation: a. review of reviews on the. diagnostic accuracy of. brief cognitive assessments for identifying dementia in primary care
Abstract.
Hunt HA (2015). Constructing an overview of systematic reviews of diagnostic test accuracy. 23rd Cochrane Colloquium. 3rd - 7th Oct 2015.
Abstract:
Constructing an overview of systematic reviews of diagnostic test accuracy
Abstract.
Hyde CJ, Hunt HA (2015). Test evaluation and decision making – what further information is needed? (workshop). 23rd Cochrane Colloquium. 3rd - 7th Oct 2015.
Abstract:
Test evaluation and decision making – what further information is needed? (workshop)
Abstract.
Hunt HA, Hardwick RJ (2013). An analysis of theory building in realist synthesis: perspectives from the literature. 21st Cochrane Colloquium 2013.
Hunt HA, Hyde CJ, Ukoumunne O, Cooper C (2013). Identifying uncontrolled haemorrhage after trauma. University of Exeter Medical School Medical and Health Research Showcase 2013.
Hunt HA, Hyde CJ, Pearson M (2013). Realist synthesis – what is it and how could it add value to the diagnosis of dementia in primary care?. Methods for Evaluating Medical Tests and Biomarkers Symposium 2013.
Zhelev Z, Hunt HA, Hyde CJ (2013). The reporting of research design of diagnostic test accuracy (DTA) studies in the abstracts in major medical journals. Methods for Evaluating Medical Tests and Biomarkers Symposium 15th – 16th July 2013; Birmingham, UK.
Zhelev Z, Hunt HA, Hyde CJ (2013). The reporting of research design of diagnostic test accuracy (DTA) studies in the abstracts in major medical journals. Methods for Evaluating Medical Tests and Biomarkers Symposium.
Zhelev Z, Hunt H, Hyde CJ (2013). Using QUADAS-2 in systematic reviews of Diagnostic Test Accuracy (DTA) studies: Survey of users’ experience. 21st Cochrane Colloquium 2013.
Pearson MN, Hunt HA, Anderson R (2012). Assessing the quality of sources in a systematic review of implementation: Reflections from a realist review. 12th Annual Colloquium of the Campbell Collaboration 2012 29th – 31st May; Copenhagen, Denmark.
Pearson MN, Hunt HA, Cooper C, Shepherd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: a realist review of what works for whom and why. Delivering better health services: Health Services Research Network Symposium 2012; 19th & 20th June; Manchester, UK.
Hunt H, Pearson M, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: developing a conceptual framework. Health Services Research Network Symposium 2012.
Reports
Garside R, Pearson M, Hunt HA, Moxham T, Anderson R (In Press).
Identifying the key elements and interactions of a whole system approach to obesity prevention. NICE Centre for Public Health Excellence, NICE.
Abstract:
Identifying the key elements and interactions of a whole system approach to obesity prevention.
Abstract.
Author URL.
Pearson M, Hunt H, Cooper C, Shepperd S, Pawson R, Anderson R (2013). Intermediate care: a realist review and conceptual framework. Final report. NIHR Service Delivery and Organisation Programme, NIHR Service Delivery and Organisation Programme.
Hunt HA, Anderson R, Coelho HF, Garside R, Bayliss S, Fry-Smith A (2012).
Preventing obesity: the effectiveness of whole system approaches. NICE Programme Development Group, NICE.
Author URL.
Hunt HA, Anderson R, Garside R, Coelho HF, Bayliss S, Fry-Smith A (2012).
Preventing obesity: the effectiveness of whole system approaches. NICE Centre for Public Health Excellence, NICE. 126 pages.
Abstract:
Preventing obesity: the effectiveness of whole system approaches
Abstract.
Author URL.
Pearson M, Hunt H, Cooper C, Shepperd S, Pawson R, Anderson R (2012).
The effective and cost-effective use of intermediate, step-down, hospital at home and other forms of community care as an alternative to acute inpatient care: a realist review., NIHR.
Author URL.
Hunt H, Anderson R (2011). Whole system approaches to obesity prevention case studies: Analysis of documentary evidence from three localities – Sheffield, Newcastle-upon-Tyne, and Barking & Dagenham.
Garside R, Pearson M, Hunt H, Moxham T, R A (2010).
Preventing obesity using a ‘whole system’ at local and community level: Identifying the key elements and interactions of a whole system approach to obesity prevention. Author URL.
Pearson M, Hunt H, Garside R, Moxham T, Peters J, R A (2010).
Preventing unintentional injuries among under-15s: outdoor play and leisure – systematic review of effectiveness of educational interventions. Author URL.
Publications by year
In Press
Garside R, Pearson M, Hunt HA, Moxham T, Anderson R (In Press).
Identifying the key elements and interactions of a whole system approach to obesity prevention. NICE Centre for Public Health Excellence, NICE.
Abstract:
Identifying the key elements and interactions of a whole system approach to obesity prevention.
Abstract.
Author URL.
2022
Coon JT, Orr N, Shaw L, Hunt H, Garside R, Nunns M, Gröppel-Wegener A, Whear B (2022). Bursting out of our bubble: using creative techniques to communicate within the systematic review process and beyond.
Systematic Reviews,
11(1).
Abstract:
Bursting out of our bubble: using creative techniques to communicate within the systematic review process and beyond
Abstract
. Background
. Increasing pressure to publicise research findings and generate impact, alongside an expectation from funding bodies to go beyond publication within academic journals, has generated interest in alternative methods of science communication.
. Our aim is to describe our experience of using a variety of creative communication tools, reflect on their use in different situations, enhance learning and generate discussion within the systematic review community.
.
. Methods
. Over the last 5 years, we have explored several creative communication tools within the systematic review process and beyond to extend dissemination beyond traditional academic mechanisms.
. Central to our approach is the co-production of a communication plan with potential evidence users which facilitates (i) the identification of key messages for different audiences, (ii) discussion of appropriate tools to communicate key messages and (iii) exploration of avenues to share them. We aim to involve evidence users in the production of a variety of outputs for each research project cognisant of the many ways in which individuals engage with information.
.
. Results
. Our experience has allowed us to develop an understanding of the benefits and challenges of a wide range of creative communication tools. For example, board games can be a fun way of learning, may flatten power hierarchies between researchers and research users and enable sharing of large amounts of complex information in a thought provoking way, but they are time and resource intensive both to produce and to engage with. Conversely, social media shareable content can be quick and easy to produce and to engage with but limited in the depth and complexity of shareable information.
.
. Discussion
. It is widely recognised that most stakeholders do not have time to invest in reading large, complex documents; creative communication tools can be a used to improve accessibility of key messages. Furthermore, our experience has highlighted a range of additional benefits of embedding these techniques within our project processes e.g. opening up two-way conversations with end-users of research to discuss the implications of findings.
.
Abstract.
Sugg HVR, Richards DA, Russell A, Burnett S, Cockcroft EJ, Thompson Coon J, Cruickshank S, Doris FE, Hunt HA, Iles‐Smith H, et al (2022). Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with <scp>COVID</scp>‐19 caused by infection with the <scp>SARS‐COV</scp>‐2 virus: Results from the ‘<scp>COVID‐NURSE</scp>’ survey.
Journal of Advanced Nursing,
79(3), 1003-1017.
Abstract:
Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID‐19 caused by infection with the SARS‐COV‐2 virus: Results from the ‘COVID‐NURSE’ survey
AbstractAimsTo identify strategies used by registered nurses and non‐registered nursing care staff in overcoming barriers when providing fundamental nursing care for non‐invasively ventilated inpatients with COVID‐19.DesignOnline survey with open‐ended questions to collect qualitative data.MethodsIn August 2020, we asked UK‐based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non‐invasively ventilated patients with COVID‐19. We analysed data using Framework Analysis.ResultsA total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non‐verbal communication with patients, using information technology to enable patients’ significant others to communicate with staff and patients, and establishing clear information‐sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self‐care and using ‘runners’ and interdisciplinary input. 3) Addressing patients’ well‐being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients’ wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks.ConclusionsOur respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well‐being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing.ImpactAs these strategies are unlikely to be exclusive to the COVID‐19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.
Abstract.
2021
Richards DA, Sugg HVR, Cockcroft E, Cooper J, Cruickshank S, Doris F, Hulme C, Logan P, Iles-Smith H, Melendez-Torres GJ, et al (2021). COVID-NURSE: evaluation of a fundamental nursing care protocol compared with care as usual on experience of care for noninvasively ventilated patients in hospital with the SARS-CoV-2 virus—protocol for a cluster randomised controlled trial.
BMJ Open,
11(5), e046436-e046436.
Abstract:
COVID-NURSE: evaluation of a fundamental nursing care protocol compared with care as usual on experience of care for noninvasively ventilated patients in hospital with the SARS-CoV-2 virus—protocol for a cluster randomised controlled trial
IntroductionPatient experience of nursing care is correlated with safety, clinical effectiveness, care quality, treatment outcomes and service use. Effective nursing care includes actions to develop nurse–patient relationships and deliver physical and psychosocial care to patients. The high risk of transmission of the SARS-CoV-2 virus compromises nursing care. No evidence-based nursing guidelines exist for patients infected with SARS-CoV-2, leading to potential variations in patient experience, outcomes, quality and costs.Methods and analysiswe aim to recruit 840 in-patient participants treated for infection with the SARS-CoV-2 virus from 14 UK hospitals, to a cluster randomised controlled trial, with embedded process and economic evaluations, of care as usual and a fundamental nursing care protocol addressing specific areas of physical, relational and psychosocial nursing care where potential variation may occur, compared with care as usual. Our coprimary outcomes are patient-reported experience (Quality from the Patients’ Perspective; Relational Aspects of Care Questionnaire); secondary outcomes include care quality (pressure injuries, falls, medication errors); functional ability (Barthell Index); treatment outcomes (WHO Clinical Progression Scale); depression Patient Health Questionnaire-2 (PHQ-2), anxiety General Anxiety Disorder-2 (GAD-2), health utility (EQ5D) and nurse-reported outcomes (Measure of Moral Distress for Health Care Professionals). For our primary analysis, we will use a standard generalised linear mixed-effect model adjusting for ethnicity of the patient sample and research intensity at cluster level. We will also undertake a planned subgroup analysis to compare the impact of patient-level ethnicity on our primary and secondary outcomes and will undertake process and economic evaluations.Ethics and disseminationResearch governance and ethical approvals are from the UK National Health Service Health Research Authority Research Ethics Service. Dissemination will be open access through peer-reviewed scientific journals, study website, press and online media, including free online training materials on the Open University’s FutureLearn web platform.Trial registration numberISRCTN13177364; Pre-results.
Abstract.
Sugg HVR, Russell A-M, Morgan L, Iles-Smith H, Richards DA, Morley N, Burnett S, Cockcroft E, Thompson Coon J, Cruickshank S, et al (2021). Fundamental nursing care in patients with the SARS-CoV-2 virus: results from the ‘COVID-NURSE’ mixed methods survey into nurses’ experiences of missed care and barriers to care. BMC Nursing, 20
Eke H, Hunt H, Ball S, Rogers M, Whear R, Allinson A, Melluish J, Lindsay C, Richardson D, Rogers J, et al (2021). Improving continence in children and young people with neurodisability: survey of current NHS practice and systematic review of effectiveness, cost-effectiveness and contextual factors that modify implementation of interventions. Health Technology Assessment
Cohen JF, Deeks JJ, Hooft L, Salameh J-P, Korevaar DA, Gatsonis C, Hopewell S, Hunt HA, Hyde CJ, Leeflang MM, et al (2021). Preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts): checklist, explanation, and elaboration.
BMJ,
372Abstract:
Preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts): checklist, explanation, and elaboration.
For many users of the biomedical literature, abstracts may be the only source of information about a study. Hence, abstracts should allow readers to evaluate the objectives, key design features, and main results of the study. Several evaluations have shown deficiencies in the reporting of journal and conference abstracts across study designs and research fields, including systematic reviews of diagnostic test accuracy studies. Incomplete reporting compromises the value of research to key stakeholders. The authors of this article have developed a 12 item checklist of preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts). This article presents the checklist, examples of complete reporting, and explanations for each item of PRISMA-DTA for Abstracts.
Abstract.
Author URL.
2020
Salameh JP, Bossuyt PM, McGrath TA, Thombs BD, Hyde CJ, MacAskill P, Deeks JJ, Leeflang M, Korevaar DA, Whiting P, et al (2020). Preferred reporting items for systematic review and meta-analysis of diagnostic test accuracy studies (PRISMA-DTA): Explanation, elaboration, and checklist.
The BMJ,
370(12).
Abstract:
Preferred reporting items for systematic review and meta-analysis of diagnostic test accuracy studies (PRISMA-DTA): Explanation, elaboration, and checklist
Systematic reviews of diagnostic test accuracy (DTA) studies are fundamental to the decision making process in evidence based medicine. Although such studies are regarded as high level evidence, these reviews are not always reported completely and transparently. Suboptimal reporting of DTA systematic reviews compromises their validity and generalisability, and subsequently their value to key stakeholders. An extension of the PRISMA (preferred reporting items for systematic review and meta-analysis) statement was recently developed to improve the reporting quality of DTA systematic reviews. The PRISMA-DTA statement has 27 items, of which eight are unmodified from the original PRISMA statement. This article provides an explanation for the 19 new and modified items, along with their meaning and rationale. Examples of complete reporting are used for each item to illustrate best practices.
Abstract.
McCartney M, Fell G, Finnikin S, Hunt H, McHugh M, Gray M (2020). Why 'case finding' is bad science.
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE,
113(2), 54-58.
Author URL.
2019
Hunt H (2019). Improving the accuracy of brief cognitive assessments when used as part of the process for identifying dementia in general practice.
Abstract:
Improving the accuracy of brief cognitive assessments when used as part of the process for identifying dementia in general practice.
Identifying dementia in general practice remains a considerable challenge, with mild to moderate stages of dementia potentially underdiagnosed in 30-50% of cases. The primary aim of this PhD thesis was to address the question “how can we improve the accuracy of brief cognitive assessments when used as part of the process for identifying dementia in general practice?”. This was carried out via a combination of secondary research through three evidence syntheses, and primary research via a survey of general practitioners with results triangulated with existing research and thesis findings.
Through the conduct of a rapid review of clinical practice guidelines (CPGs),I found a lack of consistent recommendations for general practice regarding selection and application of brief cognitive assessment (BCA) tools There was also a paucity of guidance given within the identified CPGs on tailoring BCA choice and use for specific populations. The rapid review indicates that greater clarity and consistency is needed from CPGs relating specifically to the use of BCAs as part of the process for identifying dementia in general practice. The systematic review and overview identified an absence of existing evidence. Where evidence exists, BCAs performed inconsistently and were broadly inadequate as a tool for use in general practice dementia care. Other factors beyond diagnostic accuracy render established tests ill-suited for general practice such as administration time, cost and acceptability for clinicians and patients. A number of areas are identified both in cognitive testing and research methods where progress can be made relatively simply.
This thesis demonstrates that many assumptions underlying current practice are without robust foundations, with severe implications for general practice and patient care at a time of scarce resource and growing demand. These assumptions need revising as a priority. What is needed is clear, specific, well-designed primary research to begin to unpick these complexities and realistically address the challenges presented by the identification of dementia within general practice and primary care. I provide explicit recommendations for the design and conduct of a primary comparative accuracy study alongside a trial of effectiveness and cost-effectiveness of using brief cognitive assessments as part of the process of identifying dementia in general practice in order to objectively and systematically assess the suitability of brief cognitive assessments as a tool for use in this population and setting.
Abstract.
Olsen M, Zhelev Z, Hunt H, Peters JL, Bossuyt P, Hyde C (2019). Use of test accuracy study design labels in NICE's diagnostic guidance.
Diagn Progn Res,
3Abstract:
Use of test accuracy study design labels in NICE's diagnostic guidance.
BACKGROUND: a variety of study designs are available to evaluate the accuracy of tests, but the terms used to describe these designs seem to lack clarity and standardization. We investigated if this was the case in the diagnostic guidance of the National Institute of Care and Health Excellence (NICE), an influential source of advice on the value of tests. OBJECTIVES: to describe the range of study design terms and labels used to distinguish study designs in NICE Diagnostic Guidance and the underlying evidence reports. METHODS: We carefully examined all NICE Diagnostic Guidance that has been developed from inception in 2011 until 2018 and the corresponding diagnostic assessment reports that summarized the evidence, focusing on guidance where tests were considered for diagnosis. We abstracted labels used to describe study designs and investigated what labels were used when studies were weighted differently because of their design (in terms of validity of evidence), in relevant sections. We made a descriptive analysis to assess the range of labels and also categorized labels by design features. RESULTS: from a total of 36 pieces of guidance, 20 (56%) were eligible and 17 (47%) were included in our analysis. We identified 53 unique design labels, of which 19 (36%) were specific to diagnostic test accuracy designs. These referred to a total of 12 study design features. Labels were used in assigning different weights to studies in seven of the reports (41%) but never in the guidance documents. CONCLUSION: Our study confirms a lack of clarity and standardization of test accuracy study design terms. There seems to be scope to reduce and harmonize the number of terms and still capture the design features that were deemed influential by those compiling the evidence reports. This should help decision makers in quickly identifying subgroups of included studies that should be weighted differently because their designs are more susceptible to bias.
Abstract.
Author URL.
Hunt H, Abbott R, Boddy K, Whear R, Wakely L, Bethel A, Morris C, Prosser S, Collinson A, Kurinczuk J, et al (2019). “They've walked the walk”: a systematic review of quantitative and qualitative evidence for parent-to-parent support for parents of babies in neonatal care.
Journal of Neonatal Nursing,
25(4), 166-176.
Abstract:
“They've walked the walk”: a systematic review of quantitative and qualitative evidence for parent-to-parent support for parents of babies in neonatal care
The aim of this systematic review was to explore the effects and experiences of parent-to-parent support in neonatal intensive care from the perspectives of those giving, receiving, or implementing support. Electronic database searches (14 databases; February 2018) were supplemented with forward and backward citation chasing. Study selection, data extraction and quality appraisal were performed independently by two reviewers. Fourteen studies (6 quantitative and 8 qualitative) met our inclusion criteria. Four major themes were identified in the qualitative literature: ‘trust’, ‘hope’, ‘information’, and ‘connecting’. Quantitative studies showed parent-to-parent support increased perceptions of support, reduced maternal stress, and increased mothers' confidence in the ability to care for their baby. Whilst the rich qualitative evidence suggested mostly positive experiences of parent-to-parent support from all perspectives, robust trial evidence was lacking. Furthermore, differences in models for implementing parent-to-parent support provided limited opportunities to develop recommendations to guide best practice. The protocol for this study was registered on PROSPERO, registration number CRD42018090569.
Abstract.
2018
Hunt H, Pollock A, Campbell P, Estcourt L, Brunton G (2018). An introduction to overviews of reviews: planning a relevant research question and objective for an overview.
Syst Rev,
7(1).
Abstract:
An introduction to overviews of reviews: planning a relevant research question and objective for an overview.
BACKGROUND: Overviews of systematic reviews are a relatively new approach to synthesising evidence, and research methods and associated guidance are developing. Within this paper we aim to help readers understand key issues which are essential to consider when taking the first steps in planning an overview. These issues relate to the development of clear, relevant research questions and objectives prior to the development of an overview protocol. METHODS: Initial discussions and key concepts for this paper were formed during a workshop on overview methods at the 2016 UK Cochrane Symposium, at which all members of this author group presented work and contributed to wider discussions. Detailed descriptions of the various key features of overviews and their different objectives were created by the author group based upon current evidence (Higgins J, Green S. Cochrane Handbook Syst Rev Interv. 2011;4:5, Pollock M, et al. Sys Rev. 2016;5:190-205, Pollock A, et al. Cochrane overviews of reviews: exploring the methods and challenges. UK and Ireland: Cochrane Symposium; 2016, Pieper D, et al. Res Syn Meth. 2014;5:187-99, Lunny C, et al. Sys Rev. 2016;5:4-12, Hartling L, et al. Comparing multiple treatments: an introduction to overviews of reviews. In 23rd Cochrane Colloquium; 2015, Hartling L, et al. Plos One. 2012;7:1-8, Ballard M, Montgomery P. Res Syn Meth. 2017;8:92-108) and author experiences conducting overviews. RESULTS: Within this paper we introduce different types of overviews and suggest common research questions addressed by these overviews. We briefly reflect on the key features and objectives of the example overviews discussed. CONCLUSIONS: Clear decisions relating to the research questions and objectives are a fundamental first step during the initial planning stages for an overview. Key stakeholders should be involved at the earliest opportunity to ensure that the planned overview is relevant and meaningful to the potential end users of the overview. Following best practice in common with other forms of systematic evidence synthesis, an overview protocol should be published, ensuring transparency and reducing opportunities for introduction of bias in the conduct of the overview.
Abstract.
Author URL.
Hunt H, Whear R, Boddy K, Wakely L, Bethel A, Morris C, Abbott R, Prosser S, Collinson A, Kurinczuk J, et al (2018). Parent-to-parent support interventions for parents of babies cared for in a neonatal unit-protocol of a systematic review of qualitative and quantitative evidence.
Syst Rev,
7(1).
Abstract:
Parent-to-parent support interventions for parents of babies cared for in a neonatal unit-protocol of a systematic review of qualitative and quantitative evidence.
BACKGROUND: Parents of babies admitted to neonatal units experience an arduous emotional journey. Feelings of helplessness, fear, sadness, guilt, grief and anger are common. These feelings can lead to anxiety, depression and post-traumatic stress which may persist long after discharge from the unit. Support from a parent with first-hand experience able to empathise with problems and challenges may help. This systematic review will identify quantitative and qualitative evidence to address the role of parent-to-parent support interventions for families of babies cared for in neonatal units, and combine the findings in an integrated synthesis. METHODS: We are working in collaboration with a study-specific Parent Advisory Group (PAG) of parents who have relevant and varied lived experience of having a baby in neonatal care and those who have been involved in providing peer support. With the PAG, we will carry out a systematic review bringing together all existing research on parent-to-parent support for parents of babies cared for in neonatal units. This will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol extension (PRISMA-P). We have co-produced a plain language protocol summary with the PAG which details the different stages of the project, and this is available via our website ( http://clahrc-peninsula.nihr.ac.uk/research/parent-to-parent-support ) for anyone interested in learning more about the detail of the project. DISCUSSION: all outputs will be available on the NIHR CLAHRC South West Peninsula (PenCLAHRC) website and promoted via PenCLAHRC networks as well as organisations that have been contacted throughout the project. PAG members will be involved in writing and reviewing the academic paper and final report and in co-producing dissemination products such as plain language summaries. The PAG will influence the main conclusions of the systematic review, aid interpretation and help to communicate results in the most appropriate ways. We will hold an impact conference with representatives from neonatal units, national neonatal networks, commissioners of services and parents to discuss what the findings mean for clinical practice and service provision. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018090569.
Abstract.
Author URL.
McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, Cohen JF, Deeks JJ, Gatsonis C, Hooft L, et al (2018). Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies the PRISMA-DTA Statement.
JAMA - Journal of the American Medical Association,
319(4), 388-396.
Abstract:
Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies the PRISMA-DTA Statement
IMPORTANCE Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. OBJECTIVE to develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. DESIGN Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. FINDINGS the systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. CONCLUSIONS AND RELEVANCE the 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.
Abstract.
2017
Hunt HA, Hyde CJ (2017). An overview of systematic reviews summarising the accuracy of brief cognitive assessments for identifying dementia in primary care. Methods for Evaluating Medical Tests and Biomarkers. 19th - 20th Jul 2016.
Abstract:
An overview of systematic reviews summarising the accuracy of brief cognitive assessments for identifying dementia in primary care
Abstract.
Pollock A, Campbell P, Brunton G, Hunt HA, Estcourt L (2017). Selecting and implementing overview methods: implications from five exemplar overviews.
Systematic Reviews,
6(1), 145-163.
Abstract:
Selecting and implementing overview methods: implications from five exemplar overviews
Background
Overviews of systematic reviews are an increasingly popular method of evidence synthesis; there is a lack of clear guidance for completing overviews and a number of methodological challenges. At the UK Cochrane Symposium 2016, methodological challenges of five overviews were explored. Using data from these five overviews, practical implications to support methodological decision making of authors writing protocols for future overviews are proposed.
Methods
Methods, and their justification, from the five exemplar overviews were tabulated and compared with areas of debate identified within current literature. Key methodological challenges and implications for development of overview protocols were generated and synthesised into a list, discussed and refined until there was consensus.
Results
Methodological features of three Cochrane overviews, one overview of diagnostic test accuracy and one mixed methods overview have been summarised. Methods of selection of reviews and data extraction were similar. Either the AMSTAR or ROBIS tool was used to assess quality of included reviews. The GRADE approach was most commonly used to assess quality of evidence within the reviews.
Eight key methodological challenges were identified from the exemplar overviews. There was good agreement between our findings and emerging areas of debate within a recent published synthesis. Implications for development of protocols for future overviews were identified.
Conclusions
Overviews are a relatively new methodological innovation, and there are currently substantial variations in the methodological approaches used within different overviews. There are considerable methodological challenges for which optimal solutions are not necessarily yet known. Lessons learnt from five exemplar overviews highlight a number of methodological decisions which may be beneficial to consider during the development of an overview protocol.
Abstract.
Hunt HA (2017). Testing times for dementia: How long do brief cognitive assessments actually take to carry out?. University of Exeter Academic Research Event. 11th - 12th May 2017.
Abstract:
Testing times for dementia: How long do brief cognitive assessments actually take to carry out?
Abstract.
Hunt HA, Van Kampen S, Takwoingi Y, Llewellyn DJ, Pearson M, Hyde CJ (2017). The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: a systematic review protocol. Diagnostic and Prognostic Research, 1, 1-6.
Lourida I, Kuzma E, Ranson JM, Hunt H, Talens‐Bou J, Rogers M, Thompson‐Coon J, Llewellyn DJ (2017). [P2–094]: DEVELOPMENT OF a DEMENTIA META‐EVIDENCE DATABASE (EMANATE).
2016
Hunt HA (2016). Cochrane overviews of reviews: exploring the methods and challenges. An overview of systematic reviews of diagnostic test accuracy (workshop). Cochrane UK & Ireland Symposium 2016: Impact, Innovation and Ingenuity. 15th - 16th Mar 2016.
Hunt HA (2016). How can primary care support a more effective route to dementia diagnosis?. University of Exeter Medical School Academic Research Event. 18th - 20th May 2016.
Abstract:
How can primary care support a more effective route to dementia diagnosis?
Abstract.
Hunt HA, Hyde CJ (2016). Overview (de)generation: a. review of reviews on the. diagnostic accuracy of. brief cognitive assessments for identifying dementia in primary care. 24th Cochrane Colloquium. 23rd - 27th Oct 2016.
Abstract:
Overview (de)generation: a. review of reviews on the. diagnostic accuracy of. brief cognitive assessments for identifying dementia in primary care
Abstract.
2015
Hunt HA (2015). Constructing an overview of systematic reviews of diagnostic test accuracy. 23rd Cochrane Colloquium. 3rd - 7th Oct 2015.
Abstract:
Constructing an overview of systematic reviews of diagnostic test accuracy
Abstract.
Pearson M, Hunt HA, Cooper C, Shepperd S, Pawson R, Anderson R (2015). Providing effective and preferred care closer to home: a realist review of intermediate care. Health and Social Care in the Community, 2(23).
Hyde CJ, Hunt HA (2015). Test evaluation and decision making – what further information is needed? (workshop). 23rd Cochrane Colloquium. 3rd - 7th Oct 2015.
Abstract:
Test evaluation and decision making – what further information is needed? (workshop)
Abstract.
Hunt HA, Stanworth S, Curry N, Wolley T, Cooper C, Ukoumunne O, Zhelev Z, Hyde C (2015). Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding. Cochrane Database of Systematic Reviews 2015(2).
2013
Hunt HA, Hardwick RJ (2013). An analysis of theory building in realist synthesis: perspectives from the literature. 21st Cochrane Colloquium 2013.
Hunt HA, Hyde CJ, Ukoumunne O, Cooper C (2013). Identifying uncontrolled haemorrhage after trauma. University of Exeter Medical School Medical and Health Research Showcase 2013.
Pearson M, Hunt H, Cooper C, Shepperd S, Pawson R, Anderson R (2013). Intermediate care: a realist review and conceptual framework. Final report. NIHR Service Delivery and Organisation Programme, NIHR Service Delivery and Organisation Programme.
Hunt HA, Hyde CJ, Pearson M (2013). Realist synthesis – what is it and how could it add value to the diagnosis of dementia in primary care?. Methods for Evaluating Medical Tests and Biomarkers Symposium 2013.
Zhelev Z, Hunt HA, Hyde CJ (2013). The reporting of research design of diagnostic test accuracy (DTA) studies in the abstracts in major medical journals. Methods for Evaluating Medical Tests and Biomarkers Symposium 15th – 16th July 2013; Birmingham, UK.
Zhelev Z, Hunt HA, Hyde CJ (2013). The reporting of research design of diagnostic test accuracy (DTA) studies in the abstracts in major medical journals. Methods for Evaluating Medical Tests and Biomarkers Symposium.
Hunt HA, Hyde CJ, Stanworth S, Curry N, Perel P, Woolley T, Cooper C, Ukoumunne O (2013). Thromboelastography (TEG) and thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding [Protocol]. Cochrane Database of Systematic Reviews 2013
Zhelev Z, Hunt H, Hyde CJ (2013). Using QUADAS-2 in systematic reviews of Diagnostic Test Accuracy (DTA) studies: Survey of users’ experience. 21st Cochrane Colloquium 2013.
2012
Pearson MN, Hunt HA, Anderson R (2012). Assessing the quality of sources in a systematic review of implementation: Reflections from a realist review. 12th Annual Colloquium of the Campbell Collaboration 2012 29th – 31st May; Copenhagen, Denmark.
Pearson M, Hunt HA, Anderson R (2012). Assessing the quality of sources in a systematic review of implementation: Reflections from a realist review.
Pearson MN, Hunt HA, Cooper C, Shepherd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: a realist review of what works for whom and why. Delivering better health services: Health Services Research Network Symposium 2012; 19th & 20th June; Manchester, UK.
Pearson P, Hunt HA, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: a realist review of what works for whom and why.
Hunt H, Pearson M, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: developing a conceptual framework. Health Services Research Network Symposium 2012.
Hunt HA, Pearson P, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: developing a conceptual framework.
Hunt HA, Anderson R, Coelho HF, Garside R, Bayliss S, Fry-Smith A (2012).
Preventing obesity: the effectiveness of whole system approaches. NICE Programme Development Group, NICE.
Author URL.
Hunt HA, Anderson R, Garside R, Coelho HF, Bayliss S, Fry-Smith A (2012).
Preventing obesity: the effectiveness of whole system approaches. NICE Centre for Public Health Excellence, NICE. 126 pages.
Abstract:
Preventing obesity: the effectiveness of whole system approaches
Abstract.
Author URL.
Pearson M, Hunt H, Garside R, Moxham T, Peters J, Anderson R (2012). Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs.
Inj Prev,
18(2), 113-123.
Abstract:
Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs.
INTRODUCTION: Unintentional injuries to children in the outdoors have a significant impact on child mortality, development and healthcare costs. This paper presents the findings of a systematic review about the effectiveness of programs that provided information, advice or education about the prevention of unintentional injuries to children under 15 years during outdoor play and leisure. METHODS: a structured search strategy was conducted in a range of databases. All report titles and abstracts were screened using pre-defined criteria. Included reports were quality appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) tool. All quality appraisals and data extraction were checked by a second reviewer. If not provided in the original reports, ORs and mean differences were calculated, where sufficient data were available. RESULTS: Twenty-three studies met the inclusion criteria. There was a paucity of robust study designs. The majority of studies only reported a short-term follow-up of intermediate outcome measures. Only two studies measured injury rates; both reported a reduction, but both studies also had considerable methodological weaknesses. The five studies that measured the use of protective equipment reported mixed results, although there is some evidence that suggests that more extensive educational programs (such as health fairs and media campaigns) increase their use. The 20 studies that measured behaviour, attitude or knowledge outcomes reported highly mixed results. DISCUSSION: Methodological weaknesses of the included studies limit support for a particular course of action. To better inform policy and practice, future research should (1) use robust study designs and (2) not rely on short-term proxy outcome measures.
Abstract.
Author URL.
Pearson M, Hunt H, Cooper C, Shepperd S, Pawson R, Anderson R (2012).
The effective and cost-effective use of intermediate, step-down, hospital at home and other forms of community care as an alternative to acute inpatient care: a realist review., NIHR.
Author URL.
2011
Peason MN, Hunt HA, Garside R, Moxham T, Peters J, Anderson R (2011). Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs.
Inj Prev,
2(18).
Abstract:
Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs
INTRODUCTION:
Unintentional injuries to children in the outdoors have a significant impact on child mortality, development and healthcare costs. This paper presents the findings of a systematic review about the effectiveness of programs that provided information, advice or education about the prevention of unintentional injuries to children under 15 years during outdoor play and leisure.
METHODS:
A structured search strategy was conducted in a range of databases. All report titles and abstracts were screened using pre-defined criteria. Included reports were quality appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) tool. All quality appraisals and data extraction were checked by a second reviewer. If not provided in the original reports, ORs and mean differences were calculated, where sufficient data were available.
RESULTS:
Twenty-three studies met the inclusion criteria. There was a paucity of robust study designs. The majority of studies only reported a short-term follow-up of intermediate outcome measures. Only two studies measured injury rates; both reported a reduction, but both studies also had considerable methodological weaknesses. The five studies that measured the use of protective equipment reported mixed results, although there is some evidence that suggests that more extensive educational programs (such as health fairs and media campaigns) increase their use. The 20 studies that measured behaviour, attitude or knowledge outcomes reported highly mixed results.
DISCUSSION:
Methodological weaknesses of the included studies limit support for a particular course of action. To better inform policy and practice, future research should (1) use robust study designs and (2) not rely on short-term proxy outcome measures.
Abstract.
Author URL.
Hunt H, Anderson R (2011). Whole system approaches to obesity prevention case studies: Analysis of documentary evidence from three localities – Sheffield, Newcastle-upon-Tyne, and Barking & Dagenham.
2010
Garside R, Pearson M, Hunt H, Moxham T, R A (2010).
Preventing obesity using a ‘whole system’ at local and community level: Identifying the key elements and interactions of a whole system approach to obesity prevention. Author URL.
Pearson M, Hunt H, Garside R, Moxham T, Peters J, R A (2010).
Preventing unintentional injuries among under-15s: outdoor play and leisure – systematic review of effectiveness of educational interventions. Author URL.
