P27 Evidence gap maps: A policy makers tool for navigating the evidence landscape. A case study of employment and health from the SIPHER (systems science in public health and health economics research) project

Background

Policy decisions are often made in complex, interlinked systems. Providing evidence to support policy making decisions within this context presents methodological challenges. Policy makers have multiple information needs, looking at broader topics. In contrast systematic reviews usually address a very specific question, examining a particular intervention or exposure. In addressing the broad topic of the relationship between employment and health we undertook a mapping review and produced a mega-map as an interactive, visual web based tool. The tool allows multiple questions to be addressed and a range of types of evidence synthesis quickly identified and provides links to the abstract and full text

Methods

We used systematic approaches, searching seven bibliographic databases, to locate and include review level evidence that measured associations of employment and unemployment and with physical, psychological and social health and wellbeing outcomes. Eligible studies included systematic reviews where a feature or employment and its impact on health and social wellbeing was explored. We drew on 'rapid review' methods, limiting our search strategy to those reviews published since 2010 and 'umbrella review' approaches, by only included existing systematic reviews. Following involvement of our stakeholders, we constructed a framework of employment related exposures (row headings) and health and social wellbeing outcomes (column headings). The features of employment we considered was comprehensive including; employment conditions, contractual arrangements, management styles, working patterns, specific working populations, the impact of economic crises and transition periods such as returning to work. The included studies were coded using the prepared framework. Coding was undertaken by three reviews independently, using Eppi-Reviewer and Eppi-Mapper software.

Results

Initial database searches identified 4,087 potentially relevant studies, and following screening 239 systematic reviews were included in the map. The evidence gap map provides an overview of the volume, diversity and the type of evidence syntheses that have explored the relationship between aspects of employment and health and social wellbeing. The interactive table allows a visual picture of where a review exists and clicking on a relevant cell takes the user to an abstract of the review and a DOI link. Filters allow the user to identify specific population they are particularly interested in. The column and row headings can be collapsed or extended depending on the specific question being asked by the policy maker to show for example, physical health outcomes, or multiple types of physical health outcomes such as health service use, or cancer or mortality. https://eppi.ioe.ac.uk/cms/Portals/35/Maps/SIPHER_EMPLOYMENT_HEALTH.html

Conclusion

The map provides an useful tool that addresses the reality of the policy making environment, where multiple questions may be being asked and time frames in which decisions are made preclude waiting for the results a full systematic review.