Knowledge user survey and Delphi process to inform development of a new risk of bias tool to assess systematic reviews with network meta-analysis (RoB NMA tool).

BACKGROUND: Network meta-analysis (NMA) is increasingly used in guideline development and other aspects of evidence-based decision-making. We aimed to develop a risk of bias (RoB) tool to assess NMAs (RoB NMA tool). An international steering committee recommended that the RoB NMA tool to be used in combination with the Risk of Bias in Systematic reviews (ROBIS) tool (i.e. because it was designed to assess biases only) or other similar quality appraisal tools (eg, A MeaSurement Tool to Assess systematic Reviews 2 [AMSTAR 2]) to assess quality of systematic reviews. The RoB NMA tool will assess NMA biases and limitations regarding how the analysis was planned, data were analysed and results were presented, including the way in which the evidence was assembled and interpreted. OBJECTIVES: Conduct (a) a Delphi process to determine expert opinion on an item's inclusion and (b) a knowledge user survey to widen its impact. DESIGN: Cross-sectional survey and Delphi process. METHODS: Delphi panellists were asked to rate whether items should be included. All agreed-upon item were included in a second round of the survey (defined as 70% agreement). We surveyed knowledge users' views and preferences about the importance, utility and willingness to use the RoB NMA tool to evaluate evidence in practice and in policymaking. We included 12 closed and 10 open-ended questions, and we followed a knowledge translation plan to disseminate the survey through social media and professional networks. RESULTS: 22 items were entered into a Delphi survey of which 28 respondents completed round 1, and 22 completed round 2. Seven items did not reach consensus in round 2. A total of 298 knowledge users participated in the survey (14% respondent rate). 75% indicated that their organisation produced NMAs, and 78% showed high interest in the tool, especially if they had received adequate training (84%). Most knowledge users and Delphi panellists preferred a tool to assess both bias in individual NMA results and authors' conclusions. Response bias in our sample is a major limitation as knowledge users working in high-income countries were more represented. One of the limitations of the Delphi process is that it depends on the purposive selection of experts and their availability, thus limiting the variability in perspectives and scientific disciplines. CONCLUSIONS: This Delphi process and knowledge user survey informs the development of the RoB NMA tool.

Guiding Ethics Review in Pharmacy Education Research and Scholarship at UBC: Clarifying the Unclear.

While it goes without saying that ethically sound practices are imperative for high-quality educational scholarship, institutional ethics guidance is often unclear about how to treat educational scholarship generally, and quality improvement/assurance studies and the scholarship of teaching and learning, specifically. Amongst health profession education researchers, including those in pharmacy, this lack of clarity has led to confusion regarding existing ethics governance and ambivalence regarding ethics requirements. Drawing on the experiences of one pharmacy school in western Canada, this commentary describes an ethics vetting guide developed explicitly to address current uncertainty about ethics requirements for pharmacy education scholarship. Clarifying the problem, describing the guide, and exploring what was learned along the way provide a basis for re-centering ethics in the development of scholarly projects and decision-making regarding formal ethics review. The importance of instilling ethical intelligence, delineating research from quality improvement/assurance work, and addressing current gaps in ethics oversight and governance of educational scholarship are among key lessons learned during guide development along with suggestions for new institutional ethics guidance directly targeting educational scholarship to supplement current national guidelines.