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TRANSFER framework - project description


Decision makers are increasingly using evidence from systematic reviews to inform decisions and recommendations.

  • End

    Long-term project

  • Status


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  1. To guide review authors in identifying and considering factors that may influence applicability and transferability of an intervention throughout the review process in a systematic and transparent way.
  2. To present assessments of applicability and transferability in a systematic and transparent way.
  3. To support dialogue between review authors and decision makers (or those commissioning systematic reviews) 


Decision makers are increasingly using evidence from systematic reviews to inform decisions and recommendations. Studies included in a systematic review may vary considerably in terms of population characteristics, geographical location, time, or according to more complex factors such as political environment, organization of society or family and social culture. These factors can influence how generalizable review findings are to the context in which the end user is interested. This generalizability contributes to a systematic review author’s or end-user’s confidence in the evidence.

The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach can be used to support systematic review authors in assessing the quality of the evidence. Specifically, the domain «Indirectness» allows authors to indicate concerns when the population, intervention or outcomes in the included studies are different from those we are interested in, or when there are no direct comparisons between the alternative interventions. There is currently, however, no systematic and transparent approach for considering and presenting the impact of specific contextual factors on the applicability or transferability of the review findings to the context of interest.

Applicability: Whether the findings of a review can be applied in a specific context or population (The Cochrane Library. In: Higgins J, Green S, editors. Cochrane handbook for systematic reviews of interventions. Chichester, UK: John Wiley & Sons, Ltd.; 2011. No. 5.1.0: March 2011)

Transferability: Whether the level of effectiveness of the intervention when applied in a specific context or population will be similar to that observed in the systematic review (Wang S, Moss JR, Hiller JE. Applicability and transferability of interventions in evidence-based public health. Health Promot Int 2006; 21(1):76-83).


The project has evolved through two parallel streams of work: A systematic mapping of existing checklists/frameworks/guidance; and focus groups with decision makers on factors that could influence applicability and transferability.