Developing a matrix approach to identify and prioritise research recommendations

Paper summarized: Developing a matrix to identify and prioritise research recommendations in HIV Prevention” Anstee et al. BMC Public Health 2011, 11:381 

Summary of the Paper prepared by Sally Crowe

What was the purpose of the prioritisation exercise?

To evidence gaps in research in contemporary HIV prevention, using a novel approach, with the potential to aid prioritisation in future research.

What is the matrix approach?

This approach utilises existing published and unpublished research to inform gaps and priorities.
After first assessing existing mapping tools (that were assessed as too treatment focussed) the team developed a new matrix system for mapping evidence to collate publications into groups and combinations of prevention related activities (e.g. behaviour, descriptive epidemiology) risk groups (e.g. gay men, antenatal) and study types (e.g. systematic reviews, RCTs) . This was not an evidence synthesis so there was no assessment of quality of mapped studies.

How did they approach the task?

Categories for the prevention and risk groups in HIV prevention were developed with four external experts; these categories were used in the axis of the matrix; systematic searches were undertaken for HIV prevention mainly from UK, USA, Canada, Australia and New Zealand, 2006 – 2009. Inclusion and exclusion criteria are described in the account. The counts of prevention and risk groups were counted and exported to the matrix; a pilot of mapping 100 studies was undertaken.

What were the results?

869 studies were included and their counts exported to the matrix.
“First impressions from the high numbers of studies identified suggest that HIV prevention is generally a heavily researched area, however, the results shown in the matrix draw attention to some unexpected exclusions within this field. The dense, sparse and empty areas of research are visually evident within HIV prevention activities, risk groups and study types” when looking at the matrix results.
These less populated areas included; sero-sorting: identifying the undiagnosed population, law/ethics/policy, combination packages of interventions and more, these are expanded in the paper.
The visual of the matrix is easy to interpret and it is clear where there are gaps in research, as well as the groups that were more readily researched, e.g. gay men and drug users.

What were the limitations?

• Four external experts drew up the categories for the matrix; do they represent the research experience or lived experience and clinical experience?
• Should gaps in research necessarily translate to priorities?
• Is there a next step in this approach to test out these gaps with a community of interest for feedback?
• The authors talk about the problems of using counts from multiple papers from original research, they also describe the limitations of quality assurance of the included studies beyond the hierarch of evidence