Map of Evidence
What is?
The Evidence Map is a review methodology that allows the systematization and graphical representation of the evidence analyzed in review studies in an area or subarea in relation to the effect of the analyzed interventions on health outcomes.
In the Map, the selected studies are presented in a structure of interventions evaluated against measured results or outcomes, visually highlighting the gaps where there are few or no studies and where there is a concentration of them.
BIREME, taking into consideration the 3ie Evidence Gap Map model, adapted and developed a methodology for creating Evidence Maps linked to the information sources of the Virtual Health Library (VHL).
How to use?
The evidence map presents, in a matrix of interventions and outcomes, an overview and a graphic synthesis of the evidence on interventions of practices and/or therapeutic methods for specific health problems (outcomes).
The map is prepared in a process that involves a systematic search of documents in the main databases, study selection according to inclusion criteria, and subsequent characterization.
Is developed on an interactive online platform that allows users to identify existing evidence. In the matrix cells, the circles located at the intersections between the interventions and the outcomes represent the identified studies. The size of the circle represents the volume of studies. The color of the circles represents the confidence level (high, moderate, low, critically low) according to a methodological qualification of the studies included in the map. Review studies are evaluated using the AMSTAR 2 (Measurement Tool to Assess Systematic Reviews).
Hovering over a circle displays a list of the studies that the figure represents. The links for these studies lead to the full text (if open access is available) or to the corresponding record in a database of the Virtual Health Library (VHL). It is possible to filter the evidence by type, country foccus, effect of the intervention (positive, negative, etc), and population.
How to create?
The map is created by a process that involves a systematic search of documents in the main databases, study selection according to inclusion criteria, and subsequent characterization.
The follow step is creation and publication of evidence map to produce an interactive visualisation of evidence found, analyzed and categorized, in addition to linking with the bibliographic records and full texts (when available) of the studies.
And, based on the analysis of the review studies identified and analyzed, an executive report or scientific article should be organized in order to demonstrate the evidence gaps and redundancy (multiple studies of similar issues) related to specific area.
- Search
The bibliographic search for scientific evidence will be carried out in electronic databases with the help of librarians and complemented by manual search and/or indication of specialists collaborating on the project. - Selection
In this stage of the project, the scientific evidence (scientific articles) identified in the bibliographic search will be evaluated according to previously defined criteria. - Characterization / Categorizatio
In this stage, data from the studies included in the previous stage will be extracted considering previously defined categories and reading the full texts of the selected studies. - Interactive visualisation
The creation and publication of evidence maps consists of graphically representing the evidence found, analyzed and categorized, in addition to linking with the bibliographic records and full texts (when available) of the evidence studies. Tableau Public is the tool being applied by BIREME to generate and publish an interactive visualization evidence map. - Report (Gaps, Redundancy)
Based on the analysis of the review studies identified and analyzed, an executive report or scientific article should be organized in order to demonstrate the evidence gaps and redundancy (multiple studies of similar issues) related to specific area, contributing to the establishment of national research agencies research priorities and among researchers.
Course
Search and Selection the Evidence
Search
The bibliographic search for scientific evidence will be carried out in electronic databases with the help of librarians and complemented by manual search and/or indication of specialists collaborating on the project. Activities:
- Identification and selection of information sources (databases and journals) that will be consulted;
- Development of electronic search expressions according to the selected databases;
- Conducting the manual search and/or indicating revisions, not identified in the electronic search;
- Metadata exportation of the bibliographic records retrieved in the bibliographic search (electronic and manual);
- Importing metadata from bibliographic records into a bibliographic reference manager (e.g: Rayyan, Endnote, Mendeley); and
- Documentation with a detailed description of all bibliographic searches performed.
Selection
The selection of studies (the scientific evidence) identified in the bibliographic search will be evaluated according to previously defined criteria. Activities:
- Analysis of the articles identified in the first stage to confirm compliance with the predefined inclusion criteria;
- Classification of selected evidence in pairs; preferably with blinding, using software (e.g.: Rayyan); and
- Exporting metadata of selected studies to a spreadsheet or other platform (e.g. RedCap).
Evidence Characterization
In this stage, data from the studies included in the previous stage will be extracted considering previously defined categories and reading the full texts of the selected studies. This step is crucial for associate and represent graphically the evidence on the map.
The categorization (characterization) of the evidence can be divided into groups of data:
✔ Study identification data
Title, Year of Publication, Country of Publication, Identification number in the database (where the article is indexed).
✔ Evidence analyzed in studies
In general, interventions and outcomes are spelled out in the objective or purpose of a review study. The same study may analyze one or more interventions for one or more outcomes.
✔ Methodological quality of studies
Evaluation and classification of studies by quality criteria to establish the confidence level of the evidence reported for the intervention/outcome/effect associations (for example: AMSTAR2 in the case of systematic reviews and overviews).
Interactive Evidence Map
The map itself is the result of processing the data characterized and represented in a spreadsheet that will generate a graphical view of the mapped evidence relating the interventions to the outcomes. Each relationship is plotted on the map with a bubble that can vary in size (according to the number of studies that reported that relationship) and color (according to the confidence level of the reported evidence).
Filters for viewing the relationships are available and can be selected by the user to filter, for example, type of population, effect of the intervention on the outcome, among other filters.
The filters available on the map depend on the data that was included in the characterization and defined at the beginning of the map construction work. For example, the intervention/outcome target population filter is data that, if collected, could be an interesting filter.
Tableau Public is the tool applied by BIREME to generate and publish an interactive visualization evidence map.
Evidence Maps Portal
BIREME have been doing quite a lot of work on Evidence Maps (since 2019), mainly on Traditional and Complementary Medicine (T&CM), but also on other topics.
The list of Evidence Maps developed is available at the Evidence Maps Portal Evidence Map
Want to know more?
This publication describes that Evidence Map methodology developed by BIREME - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064289/
If you interested in creating an evidence map based on that methodology, access the free online course available at Public Health Virtual Campus:
Evidence Map: how to apply the methodology