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Identifying uncertainties: DUETs and the NLH Specialist Libraries. Douglas Grindlay University of Nottingham. National Library for Health. Scope of talk. What is DUETs? Why are the NLH Specialist Libraries in such a good position to compile uncertainties for DUETs?

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identifying uncertainties duets and the nlh specialist libraries

Identifying uncertainties: DUETs and the NLH Specialist Libraries

Douglas Grindlay

University of Nottingham

National Library for Health

scope of talk
Scope of talk
  • What is DUETs?
  • Why are the NLH Specialist Libraries in such a good position to compile uncertainties for DUETs?
  • Sources of uncertainties for DUETS, and progress so far…
slide4
DUETs:
  • The Database of Uncertainties about the Effects of Treatments

www.duets.nhs.uk

  • A resource to help prioritise new research
  • Uncertainties that cannot be answered by reliable, up-to-date systematic reviews
slide5
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
slide6
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
slide7

Criteria for DUETS uncertainties:

  • 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
slide9

Example: The NLH Skin Disorders Specialist Library

  • “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
the nlh skin disorders specialist library
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!
skin disorders library community stakeholders
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
skin disorders library community stakeholders cont
Skin Disorders Library community & stakeholders (cont.)
  • Health academics
  • Health students
  • Health librarians
  • Health information specialists
  • Patients and public
  • Patient support groups
communication with our community
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
annual evidence updates
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
implications for duets
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
the duets skin module
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
uncertainties invited from patient groups
Uncertainties invited from patient groups
  • January 2007 – asked National Eczema Society, Psoriasis Association and Acne Support Group for patient questions
uncertainties invited from patient groups cont
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
uncertainties invited from health professionals
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
uncertainties identified from systematic reviews
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
link to national knowledge weeks
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
future tasks
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
conclusions
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
conclusions cont
Conclusions (cont.)
  • 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