Information Practice as Dialogue: The Case for Collaboration in Evidence Searching and Finding for More Complex Reviews

Abstract

Cochrane Consumers and Communication Group's (CCC) approach to evidence searching has evolved over time in the context of Cochrane's rigorous methodological advice [1, 2]. CCC is a Cochrane review group responsible for coordinating the preparation and publication of evidence syntheses that affect the way people interact with healthcare professionals, services and researchers. CCC includes a highly skilled Information Specialist who collaborates with CCC author teams to design a rigorous search strategy to gather evidence to answer the review question. In this commentary, we discuss the transformation of the information practice of searching in CCC from being a largely technical exercise conducted solely by the Information Specialist to a collaborative dialogue between the Information Specialist and author teams.

A key reason for the transformation in our search methods has been that CCC reviews tend to be complex, with review questions that are generally not as easily answered as clinically focused reviews. Our research, and information practice specifically, is contextualized and guided by a three-way dynamic of patient preferences and experiences, research evidence, and professional expertize. The reviews are rigorous in their examination of evidence on people's healthcare interactions, including how people self-manage health and disease, understand screening, health and treatment, and negotiate and share decisions with healthcare professionals within systems and different settings. However, interventions to change behaviors, to educate, support and up-skill people to participate actively in their healthcare, are often complex, multifaceted and their effects evaluated via multiple diverse outcomes [3]. This complexity necessarily shapes our methods of information practice.

Early in the life of CCC and for many years, we viewed searching as a largely solitary technical exercise performed by a skilled Information Specialist following conventional, rigorous Cochrane search methods. Often this required labor-intensive search development, resulting in delays for search results and an excessive screening obligation (e.g., some review questions resulted in authors needing to screen more than 25,000 search results). As volume and complexity of literature in the health communication area increased, we moved towards search strategies developed with practicalities of reference screening in mind [4, 5]. We have since developed transparent and pragmatic search strategies by means of embedded and open dialogue [6] with authors. In the context of increasing topic complexity and rigorous information searching, this approach maximizes identification of relevant references while avoiding unmanageable reference numbers for screening.

In this commentary, we explore CCC's approach to searching and its evolution over time in the context of Cochrane's rigorous methodological advice. We illustrate different approaches to achieving this balance between rigour and the practical demands of review production. To demonstrate our approach, we will discuss two recent CCC reviews [7, 8] that showcase the development of our current practices.

Developments of the evidence-based practice (EBP) process and methods in the last 30 years have added nuance and depth to collective knowledge in healthcare. For the EBP methods to remain gold standard and useful, researchers and Information Specialists have added layers of procedural sophistication at all steps of the EBP chain. Information Specialists bring unique skills to the field of evidence synthesis and there is growing recognition of the value of their contribution in identifying and managing large and diverse evidence sources [14, 15]. Search, our example here, has moved from being modeled on a basic PICO framework run primarily in databases to one of increasingly sophisticated choices between evidence sources and search terms to describe and inform the concepts contained within search questions.

Search now calls for dialogue with interest holders. This can be managed by the Information Specialist, whose task is to balance the often complex concepts against the time and effort required to address the answerable search question(s). To achieve this dialogue, Information Specialists must be integrated and embedded into the processes of review production [14, 16]. We have found that only through iterative testing and dialogue can we achieve rigorous but manageable search results in an effective balance of the art with the science of evidence retrieval.

Parkhill Anne: conceptualization, investigation, writing − original draft, writing − review and editing, project administration, funding acquisition. Merner Bronwen: conceptualization, writing − original draft, writing − review and editing, project administration, investigation, funding acquisition. Ryan Rebecca: conceptualization, investigation, writing − original draft, writing − review and editing, project administration, supervision, funding acquisition.

The authors declare no conflicts of interest.