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About this publication
NOKC published 23 systematic reviews and HTA-reports in 2012, commissioned by health care decision-makers in Norway. All reports include recommendations for further research. The aim of this report is to point to research gaps on topics of interest to decision-makers in the Norwegian health care setting.
Methodological research gaps:
- Studies that comply with recommendations for conduct and reporting of trials (such as CONSORT, STROBE, STARD)
- Relevant outcome measures, appropriate study power and adequate follow-up
- Direct comparisons between relevant interventions. Patients should be involved in research planning so that studies include outcomes considered important by patients.
Clinical research gaps
- Long term follow up of preventative measures for drug addiction in adolescents
- Preventive measure for smoking initiation among adolescents
- Preventive measure for physical activity and healthy eating among children and adolescents.Promotion of social health for children and adolescents
- Effect of interventions provided by community organised “healthy living centers” that advice the populations on “healthy living”
- Early ultrasound in pregnancy week 10-13:
- Effect on number of abortions
- Mental health of the pregnant woman
- Diagnostic accuracy for serious malformations
- The impact of early information to support informed decision-making.
- Antibiotic treatment for Lyme disease:
- Need for controlled trials that assess different dose and treatment duration, as well as different combinations of antibiotics
- Need for studies conducted in Norway due to geographical variation in subgroups of Borrelia burgdorferi.
- Effect of long-term mechanical ventilation (LTMV) for patients with neuromuscular disease, central respiratory failure, thoracic restrictive disorders or adipositas hypoventilation syndrome Effect of psychological treatments for non-specific chronic pain, especially to identify which treatment component is effective and to identify client populations that may benefit from that specific treatment.
- Interventions for reducing seclusion and restraint in mental health
- Comparative studies that evaluates joint crisis plans
- Regular assessment of aggressive behaviour
- Outreach teams, acute teams, treatment contacts.
- There is an evidence gap of research to assess the effects of GPs' list size on the quality of primary care physician services
- Effect of a joint public emergency number compared with separate emergency lines for each emergency agency on health service performance, patient survival and other health-related outcomes
- Effects of support and follow-up interventions for people with severe mental illness:
- More studies with larger study populations in order to identify meaningful differences
- Evidence on the effects of interventions such as recreational and leisure activities and supported housing and follow-up measures
- Future studies should aim to include mortality, quality of life, knowledge, skills, empowerment, patient satisfaction and costs.
- Interventions in the research literature are not representative for the magnitude of treatment methods that are offered for sexual problems and dysfunctions in men and women.
- The effects of sexual therapy interventions for sexual problems:
- Need for well conducted randomised controlled trials
- Research on sexual minorities and sexually abused populations
- Research on populations with mental retardation, mental illness and chronic diseases
- Research on effect of sexological interventions for people with questions on sexual identity
- Research on effective components of sexual therapeutic interventions
- Validation of outcomes
- Stepped wedged randomised controlled design to evaluate multidisciplinary, team-based rehabilitation, including education, in rheumatoid arthritis
- Interventions for Tobacco Control in Low- and Middle-income countries (LMIC):
- More rigorous studies conducted in LMICs, perhaps with a particular focus on delivery strategies of therapies that have been successful in high income settings
- Some interventions such as those targeting the supply of tobacco, enforcing bans on tobacco advertising or raising taxes require further evaluation, especially in LMIC where the legislation and enforcement of tobacco control varies widely.
- There is uncertainty about whether interventions to facilitate secondary transitions for youth with disabilities are effective. Drawing on existing knowledge we conclude that there is a need for a systematic review of high methodological quality to address the question of which interventions work for which groups under which conditions.
Many of the methodological research gaps identified in this report are the same as previous years. Many gaps can easily be improved to reduce wasted research-resources. There is an increasingly ethical challenge that the efforts from patients and researchers does not translate into high quality research.