In the USA, the pace of generating research is a multi-year process. Most research grants are a long journey that will entail planning, hypothesis generation, study implementation, analysis, and findings synthesis. This journey can take three to five years to complete. Compare this with the roadmap for many digital health tools, a multi-year process but with a very different cadence and another purpose; to get a digital tool into a consumers hands. How can we better align evidence generation with ensuring digital tools solve for the right clinical issues?
A new comment piece by Katherine Lewinter from Children’s Hospital, Los Angeles, published in Nature Digital Medicine, speaks to the role of scoping reviews in digital medicine with specific emphasis on pediatrics populations. The authors reflect on the issues regarding the long road of research, and the fast pace of digital health that are currently at odds. This lack of alignment is even more pronounced in pediatric populations where research is not funded to the same extent as adult populations and this lack of funding seems to be a growing issue.
Twenty-four percent of published systematic reviews and meta-analysis (a study of studies) were in the pediatric realm. Additionally, a newer methodology known as a scoping review has also seen about twenty-five percent representation in pediatrics. In essence, scoping reviews are designed to provide an overview of available research evidence without the need to answer a discrete research question. This research tool is growing in popularity.
The authors suggest that scoping reviews might be a prudent bridge to the rapidly evolving digital health space. Still, they are not without controversy. They are often viewed as less rigorous than a systematic review or meta-analysis; this could be addressed by having a standardized reporting approach.
In a phased model of evidence generation, the value proposition of scoping reviews is clear. It can build a bridge to inform the traditional level of research inquiry. The pace of research is a 3-5 year journey. The speed of implementation and learning from digital tools is much faster than that. This gap may is even more pronounced in pediatrics and warrants closing to advance care delivery. Some intellectual knitting of approaches and strategies seems like a prudent next step in advancing digital health.
Thanks for reading – Trina
(Opinions are my own)
References
Lewinter, K.E., Hudson, S.M., Kysh, L. et al. Reconsidering reviews: the role of scoping reviews in digital medicine and pediatrics. npj Digit. Med. 3, 158 (2020). https://doi.org/10.1038/s41746-020-00368-2
