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1.
J Clin Epidemiol ; 170: 111343, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38582403

RESUMO

Scoping reviews can identify a large number of evidence sources. This commentary describes and provides guidance on planning, conducting, and reporting large scoping reviews. This guidance is informed by experts in scoping review methodology, including JBI (formerly Joanna Briggs Institute) Scoping Review Methodology group members, who have also conducted and reported large scoping reviews. We propose a working definition for large scoping reviews that includes approximately 100 sources of evidence but must also consider the volume of data to be extracted, the complexity of the analyses, and purpose. We pose 6 core questions for scoping review authors to consider when planning, developing, conducting, and reporting large scoping reviews. By considering and addressing these questions, scoping review authors might better streamline and manage the conduct and reporting of large scoping reviews from the planning to publishing stage.

2.
Campbell Syst Rev ; 20(2): e1392, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38510060

RESUMO

This is a protocol for a Campbell Review following JBI scoping review methodology. The objectives are to answer the following questions: What has been reported in the literature about collaborative learner-educator design, implementation, or evaluation of learner assessment in health professional education? (1) Where is learner-educator co-creation of assessment occurring? (i.e., which disciplines, course types, level of learner, year of study). (2) What course assessment decisions are influenced or being made together? (i.e., assessment instructions and/or grades). (3) How much influence do learners have on decision-making? (i.e., where does it fall on Bovill and Bulley's ladder of participation). (4) How do learners and educators go about making decisions together? (i.e., discussion or voting, with a whole class or portion of the class). (5) What are the perceived benefits, disadvantages, barriers, and/or facilitators reported by the authors?

3.
J Clin Epidemiol ; 170: 111333, 2024 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-38522755

RESUMO

OBJECTIVES: The proliferation of evidence synthesis methods makes it challenging for reviewers to select the ''right'' method. This study aimed to update the Right Review tool (a web-based decision support tool that guides users through a series of questions for recommending evidence synthesis methods) and establish a common set of questions for the synthesis of both quantitative and qualitative studies (https://rightreview.knowledgetranslation.net/). STUDY DESIGN AND SETTING: A 2-round modified international electronic modified Delphi was conducted (2022) with researchers, health-care providers, patients, and policy makers. Panel members rated the importance/clarity of the Right Review tool's guiding questions, evidence synthesis type definitions and tool output. High agreement was defined as at least 70% agreement. Any items not reaching high agreement after round 2 were discussed by the international Project Steering Group. RESULTS: Twenty-four experts from 9 countries completed round 1, with 12 completing round 2. Of the 46 items presented in round 1, 21 reached high agreement. Twenty-seven items were presented in round 2, with 8 reaching high agreement. The Project Steering Group discussed items not reaching high agreement, including 8 guiding questions, 9 review definitions (predominantly related to qualitative synthesis), and 2 output items. Three items were removed entirely and the remaining 16 revised and edited and/or combined with existing items. The final tool comprises 42 items; 9 guiding questions, 25 evidence synthesis definitions and approaches, and 8 tool outputs. CONCLUSION: The freely accessible Right Review tool supports choosing an appropriate review method. The design and clarity of this tool was enhanced by harnessing the Delphi technique to shape ongoing development. The updated tool is expected to be available in Quarter 1, 2025.

4.
PLoS One ; 19(3): e0297535, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38457470

RESUMO

Social prescribing is suited to all age groups, but it is especially important for children and youth, as it is well understood that this population is particularly vulnerable to the effects of the social determinants of health and health inequities, and that intervening at this stage of life has the greatest impact on health and wellbeing over the life course. While this population has largely been neglected in social prescribing research, policy, and practice, several evaluations of social prescribing for children and youth have emerged in recent years, which calls for a review of the evidence on this topic. Thus, the objective of this scoping review is to map the evidence on the use of social prescribing for children and youth. This review will be conducted in accordance with the JBI methodology for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategy will aim to locate both published and unpublished literature. No language or date restrictions will be placed on the search. The databases to be searched include MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), AMED (Ovid), ASSIA (ProQuest), Sociological Abstracts (ProQuest), Global Health (Ovid), Web of Science (Clarivate), Epistemonikos, JBI EBP Database (Ovid), and Cochrane Library. Sources of gray literature to be searched include Google, Google Scholar, Social Care Online (Social Care Institute for Excellence), SIREN Evidence and Resource Library (Social Interventions Research and Evaluation Network), and websites of social prescribing organizations and networks. Additionally, a request for evidence sources will be sent out to members of the Global Social Prescribing Alliance. Two independent reviewers will perform title and abstract screening, retrieval and assessment of full-text evidence sources, and data extraction. Data analysis will consist of basic descriptive analysis. Results will be presented in tabular and/or diagrammatic format alongside a narrative summary.


Assuntos
Desigualdades de Saúde , Políticas , Adolescente , Criança , Humanos , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
6.
JBI Evid Synth ; 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38230447

RESUMO

OBJECTIVE: This scoping review aims to provide a comprehensive summary of the biological, psychological, and sociological risk factors for intimate partner violence (IPV) victimization and perpetration reported after the onset of the COVID-19 pandemic. INTRODUCTION: IPV is a significant public health concern, characterized by various forms of violence inflicted by intimate partners. The onset of the COVID-19 pandemic significantly increased the global prevalence of IPV. While prior research has identified factors linked to IPV, the risk factors reported in the literature during this period have not been systematically mapped. Additionally, the similarities and differences in risk factors between perpetration and victimization have not been well delineated. INCLUSION CRITERIA: This review will focus on individuals aged 12 years or older involved in dyadic romantic relationships. Primary studies and systematic reviews published from the year 2020 will be included. Full-text papers, preprints, theses, and dissertations published in English will be included. Studies focusing on factors unrelated to IPV risk will be excluded. Non-systematic reviews, opinion pieces, and protocols will also be excluded. METHODS: Following the JBI methodology for scoping reviews, systematic searches will be conducted for both peer-reviewed and gray literature. Independent reviewers will screen records, select eligible studies, and extract data using a standardized form. Key risk factors will be mapped to explore their interplay. DETAILS OF THE REVIEW ARE AVAILABLE IN OPEN SCIENCE FRAMEWORK: https://osf.io/c2hkm.

7.
J Prim Care Community Health ; 14: 21501319231201080, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37740528

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease. Most of the care for this population occurs within the primary care setting; however, the extent to which different primary care practice models influence the outcomes of patients with COPD remains unclear. OBJECTIVE: The study aimed to compare and analyze the influence of different primary care practice models on indicators of unplanned health care utilization among newly diagnosed COPD patients in Ontario. DESIGN: A retrospective cohort study was conducted using health administrative database within the Institute for Clinical Evaluative Sciences. The cohort included persons who were 35 years and older with physician-diagnosed COPD between January 1, 2014 and December 31, 2019. Patients were assigned into 3 practice models: team-based, traditional, and no enrolment. The primary outcomes examined was unplanned health care utilization, specifically emergency department (ED) visits and hospitalizations. To account for excessive zero values, the zero inflated negative binomial (ZINB) models were used to analyze the association between different practice models and unplanned health care utilization. RESULTS: Among 57,145 individuals who met the inclusion criteria, 55,994 were included in the regression analysis. Of the included participants, 62.8% of patients were in the traditional group, 30.3% were in the team-based group, and 6.9% were in the no enrolment group. Between 2014 and 2019, 70.7% of the cohort had at least 1 all-cause ED visit without hospitalization. The adjusted ZINB models showed no significant difference in risks of experiencing an unplanned health care utilization between the team-based and traditional groups. However, patients in the no enrolment group had a significantly higher risk of ED visit without hospitalization regardless of cause, ED visit with hospitalization regardless of cause, and 30-day readmissions regardless of cause. CONCLUSIONS: Primary care practice models are complex, influenced by remuneration and organizational structures, reinforcing the need for further research to enhance our understanding of primary care reforms. Furthermore, given the growing shortage of primary care providers, patients with COPD and other chronic conditions are particularly vulnerable.

8.
BMJ Open ; 13(7): e070184, 2023 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-37451718

RESUMO

OBJECTIVE: The aim of this study was to establish internationally accepted conceptual and operational definitions of social prescribing. DESIGN: A three-round Delphi study was conducted. SETTING: This study was conducted virtually using an online survey platform. PARTICIPANTS: This study involved an international, multidisciplinary panel of experts. The expert panel (n=48) represented 26 countries across five continents, numerous expert groups and a variety of years of experience with social prescribing, with the average being 5 years (range=1-20 years). RESULTS: After three rounds, internationally accepted conceptual and operational definitions of social prescribing were established. The definitions were transformed into the Common Understanding of Social Prescribing (CUSP) conceptual framework. CONCLUSION: This foundational work offers a common thread-a shared sense of what social prescribing is, which may be woven into social prescribing research, policy and practice to foster common understanding of this concept.


Assuntos
Projetos de Pesquisa , Software , Humanos , Técnica Delphi , Consenso , Inquéritos e Questionários
9.
Int J Integr Care ; 23(1): 3, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36741971

RESUMO

Introduction: There is currently no agreed definition of social prescribing. This is problematic for research, policy, and practice, as the use of common language is the crux of establishing a common understanding. Both conceptual and operational definitions of social prescribing are needed to address this gap. Therefore, the aim of the study that is outlined in this protocol is to establish internationally accepted conceptual and operational definitions of social prescribing. Methodology: A Delphi study will be conducted to develop internationally accepted conceptual and operational definitions of social prescribing with an international, multidisciplinary panel of experts. It is anticipated that this study will involve approximately 40 participants (range = 20-60 participants) and consist of 3-5 rounds. Consensus will be defined a priori as ≥80% agreement. Discussion: Not only will these definitions serve to unite the social prescribing community, but they will also inform research, policy, and practice. By laying the groundwork for the formation of a robust evidence base, this foundational work will support the advancement of social prescribing and help to unlock the full potential of the social prescribing movement. Conclusion: This important work will be foundational and timely, given the rapid spread of the social prescribing movement around the world.

12.
JBI Evid Synth ; 21(1): 6-32, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-35942617

RESUMO

OBJECTIVE: The objective of this scoping review was to explore how absorptive capacity has been conceptualized and measured in studies of innovation adoption in health care organizations. INTRODUCTION: Current literature highlights the need to incorporate knowledge translation processes at the organizational and system level to enhance the adoption of new knowledge into practice. Absorptive capacity is a set of routines and processes characterized by knowledge acquisition, assimilation, transformation, and application. A key concept in organizational learning theory, absorptive capacity is thought to be critical to the adoption of new knowledge and innovations in organizations. To understand how absorptive capacity was conceptualized and measured in health care organizations, it was appropriate to conduct a scoping review to answer our research question. INCLUSION CRITERIA: This scoping review included published and unpublished primary studies (ie, experimental, quasi-experimental, observational, and qualitative study designs), as well as reviews that broadly focused on the adoption of innovations at the organizational level in health care, and framed innovation adoption as processes that rely on organizational learning and absorptive or learning capacity. METHODS: Searches included electronic databases (ie, MEDLINE, Embase, PsycINFO, CINAHL, and Scopus) and gray literature, as well as reference scanning of relevant studies. Study abstracts and full texts were screened for eligibility by two independent reviewers. Data extraction of relevant studies was also done independently by two reviewers. All discrepancies were addressed through discussion or adjudicated by a third reviewer. Synthesis of the extracted data focused on descriptive frequencies and counts of the results. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS: The search strategies identified a total of 7433 citations. Sixteen papers were identified for inclusion, including a set of two companion papers, and data were extracted from 15 studies. We synthesized the objectives of the included studies and identified that researchers focused on at least one of the following aspects: i) exploring pre-existing capacity that affects improvement and innovation in health care settings; ii) describing factors influencing the spread and sustainability of organizations; iii) identifying measures and testing the knowledge application process; and iv) providing construct clarity. No new definitions were identified within this review; instead existing definitions were refined to suit the local context of the health care organization in which they were used. CONCLUSIONS: Given the rapidly changing and evolving nature of health care, it is important to understand both current best practices and an organization's ability to acquire, assimilate, transform, and apply these practices to their specific organization. While much research has gone into developing ways to implement knowledge translation, understanding an organization's internal structures and framework for seeking out and implementing new evidence as it relates to absorptive capacity is still a relatively novel concept.


Assuntos
Atenção à Saúde , Aprendizagem , Humanos , Instalações de Saúde , Estudos Observacionais como Assunto , Pesquisa Qualitativa
13.
JBI Evid Synth ; 21(3): 592-600, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35916167

RESUMO

OBJECTIVE: The objective of this scoping review is to identify evidence synthesis types and previously proposed classification systems, typologies, or taxonomies that have guided evidence synthesis. INTRODUCTION: Evidence synthesis is a constantly evolving field. There is now a plethora of evidence synthesis approaches used across many different disciplines. Historically, there have been numerous attempts to organize the types and methods of evidence synthesis in the form of classification systems, typologies, or taxonomies. This scoping review will seek to identify all the available classification systems, typologies, or taxonomies; how they were developed; their characteristics; and the types of evidence syntheses included within them. INCLUSION CRITERIA: This scoping review will include discussion papers, commentaries, books, editorials, manuals, handbooks, and guidance from major organizations that describe multiple approaches to evidence synthesis in any discipline. METHODS: The Evidence Synthesis Taxonomy Initiative will support this scoping review. The search strategy will aim to locate both published and unpublished documents utilizing a three-step search strategy. An exploratory search of MEDLINE has identified keywords and MeSH terms. A second search of MEDLINE, Embase, CINAHL with Full Text, ERIC, Scopus, Compendex, and JSTOR will be conducted. The websites of relevant evidence synthesis organizations will be searched. Identified documents will be independently screened, selected, and extracted by two researchers, and the data will be presented in tables and summarized descriptively. DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE AT: Open Science Framework https://osf.io/qwc27.


Assuntos
Literatura de Revisão como Assunto
14.
JBI Evid Synth ; 21(3): 520-532, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36081365

RESUMO

Scoping reviewers often face challenges in the extraction, analysis, and presentation of scoping review results. Using best-practice examples and drawing on the expertise of the JBI Scoping Review Methodology Group and an editor of a journal that publishes scoping reviews, this paper expands on existing JBI scoping review guidance. The aim of this article is to clarify the process of extracting data from different sources of evidence; discuss what data should be extracted (and what should not); outline how to analyze extracted data, including an explanation of basic qualitative content analysis; and offer suggestions for the presentation of results in scoping reviews.

15.
JBI Evid Synth ; 20(9): 2336-2343, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36081372

RESUMO

OBJECTIVE: The objective of this scoping review is to map the current evidence about access to health and social services for women living on a low income in Canada. INTRODUCTION: Women, especially those living on a low income, are disproportionately likely to suffer inequities in access to health and social services. There is insufficient understanding of how the interaction of socioeconomic factors and gender can affect women's access to these services. This review will provide an initial picture of what exists in the literature about access to health and social services for women living on a low income in Canada. The results of this scoping review may be used to inform subsequent qualitative and quantitative reviews on this subject. INCLUSION CRITERIA: Literature addressing access to health and social services by women who are 18 years or older and living on a low income in Canada will be considered for inclusion. Health services will include health promotion and disease prevention; treatment of medical conditions; and rehabilitation, palliative, and end-of-life care. Social services are non-medical services designed to help members of a society who may need extra support or are considered to have social or behavioral risk factors. METHODS: We will search relevant electronic databases (eg, MEDLINE, CINAHL, PsycINFO) and gray literature. The review will include all study designs, including qualitative, quantitative, and mixed methods methodologies (excluding economic analyses or clinical practice guideline development documents). Two reviewers will test the screening criteria and data extraction protocol.


Assuntos
Pobreza , Assistência Terminal , Atenção à Saúde , Feminino , Humanos , Literatura de Revisão como Assunto , Serviço Social , Fatores Socioeconômicos
16.
JBI Evid Synth ; 20(11): 2815-2823, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36081373

RESUMO

OBJECTIVE: The objective of this scoping review is to review the available information on objective performance metrics used during robotic neuroendovascular intervention procedures on humans. INTRODUCTION: Robotic neuroendovascular intervention is defined as any endovascular procedure within the vasculature of the central nervous system with the assistance of a robotic system for diagnostic or therapeutic procedures. Robotic systems are described as a 2-component system consisting of a patient-side mechanical robot, and a separate operator control station. Robotic neuroendovascular intervention is a growing field and there is a need to establish objective performance metrics for furthering evidence-based reporting of the literature. INCLUSION CRITERIA: This scoping review will consider all studies involving humans that utilize robotic neuroendovascular intervention. We will consider all types of studies, reports, and reviews as well as gray literature. Studies will be included if they describe the use of an objective performance metric during robotic neuroendovascular intervention. This review is not limited to a particular country or health care system, and will consider all study designs, regardless of their rigor or language. METHODS: Utilizing a 3-step framework as a guide, we will perform a systematic search in Embase, Cochrane Library, and MEDLINE. Available literature from inception to the present will be considered. Studies will be independently screened according to the inclusion criteria by 2 reviewers based on title, abstract, and full text. Data will be extracted, sorted, and presented in both a narrative summary as well as table and diagram based on the objective of the scoping review.


Assuntos
Procedimentos Endovasculares , Procedimentos Cirúrgicos Robóticos , Robótica , Humanos , Projetos de Pesquisa , Procedimentos Cirúrgicos Robóticos/métodos , Revisões Sistemáticas como Assunto
17.
J Clin Epidemiol ; 152: 30-35, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36179936

RESUMO

OBJECTIVES: Scoping reviews and evidence map methodologies are increasingly being used by researchers. The objective of this article is to examine how scoping reviews can reduce research waste. STUDY DESIGN AND SETTING: This article summarizes the key issues facing the research community regarding research waste and how scoping reviews can make an important contribution to the reduction of research waste in both primary and secondary research. RESULTS: The problem of research waste is an enduring challenge for global health, leading to a waste of human and financial resources and producing research outputs that do not provide answers to the most pressing research questions. Research waste occurs within primary research but also in secondary research such as evidence syntheses. The focus of scoping reviews on characterizing the nature of existing evidence on a topic and including all types of evidence, potentially reduces research waste in five ways: (1) identifying key research gaps on a topic, (2) determining appropriate outcome measures, (3) mapping existing methodological approaches, (4) developing a consistent understanding of terms and concepts used in existing evidence, and (5) ensuring scoping reviews do not exacerbate the issue of research waste. CONCLUSION: To ensure that scoping reviews do not themselves end up contributing to research waste, it is important to register the scoping review and to ensure that international reporting standards and methodological guidance are followed.


Assuntos
Projetos de Pesquisa , Pesquisadores , Humanos
18.
JBI Evid Synth ; 20(12): 3045-3057, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-35946805

RESUMO

OBJECTIVE: The objective of this review is to synthesize and appraise the available research on educational strategies required to prepare medical learners for engaging in telemedicine and virtual care. INTRODUCTION: The COVID-19 pandemic has resulted in significant uptake of virtual care and telemedicine, highlighting the growing need for health care organizations and medical institutions to support physicians and learners navigating this new model of health care delivery, clinical learning, and assessment. Developing a better understanding of how best to prepare medical trainees across the continuum of undergraduate, postgraduate, and continuing professional development to engage in virtual care is critical in ensuring our continued ability to meet educational mandates and provide ambulatory care that is safe, efficient, and timely. INCLUSION CRITERIA: Eligible studies will include medical learners who receive education on how to deliver telemedicine. The quantitative component of the review will compare learners exposed to educational interventions with learners not exposed to an intervention, or to a different intervention. Outcomes will include competencies in telemedicine delivery, knowledge, and behaviors. The qualitative component of the review will explore learners' experiences with the delivery of educational strategies that address telemedicine. METHODS: Embase, MEDLINE, Evidence-Based Medicine Reviews: Cochrane Central Register of Controlled Trials, Web of Science Core Collection, Education Source, and ProQuest Dissertations and Theses Global will be searched to identify published and unpublished studies. No date or language restrictions will be applied. This systematic review will be conducted in accordance with the JBI methodology for mixed methods systematic reviews using a convergent segregated approach. Titles and abstracts of potential studies will be screened, and potentially relevant studies will undergo full-text review for eligibility and critical appraisal of the study methodology. Data will be extracted from those studies selected for inclusion. Findings will be described relating to the effectiveness of educational curricula, initiatives, and best practices in trainee engagement in telemedicine and virtual care. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021264332.


Assuntos
COVID-19 , Educação Médica , Telemedicina , Humanos , Pandemias , COVID-19/epidemiologia , Aprendizagem , Revisões Sistemáticas como Assunto
19.
J Can Assoc Gastroenterol ; 5(2): 96-97, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35368319

RESUMO

Background: The symptom burden in inflammatory bowel disease (IBD) has a significant negative impact on the health-related quality of life (HRQOL). Patients with IBD report physical, psychological and social discomfort even during remission. Aim: To synthesize the best available evidence to determine the worldwide incidence, prevalence and determinants of discomfort in adults with inflammatory bowel disease (IBD). Methods: Following PRISMA recommendations, we searched the Medline, CINAHL, PsycInfo, Embase, Cochrane, Campbell and JBI Evidence Synthesis databases for studies on either incidence or prevalence of discomfort in English until January 2021. Data were extracted using the Joanna Briggs Institute's standardized extraction tools. Data that directly reported or could be used to calculate the incidence and prevalence of discomfort were extracted. Ten studies were eligible for inclusion in this review. Overall, the methodological quality of the included studies was considered moderate. Data measuring the incidence of discomfort in 6 out of 10 identified studies using the same measurement tool (EQ-5D) were pooled in a meta-analysis. Additional results have been presented in a narrative form, including tables. Results: There is no standardized definition or tool utilized to describe or measure discomfort in IBD. Synthesized findings demonstrate that discomfort is prevalent among adults living with IBD. Determinants of discomfort included health literacy, disease activity, hospitalization/surgery, age and gender, delayed diagnosis, local practice standards and quality of IBD care. Conclusions: More research is needed to identify the impact of discomfort on health-related outcomes for people with IBD and consequently appraise discomfort interventions for their efficacy.

20.
JBI Evid Synth ; 20(4): 969-979, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35477565

RESUMO

ABSTRACT: Knowledge user consultation is often limited or omitted in the conduct of scoping reviews. Not including knowledge users within the conduct and reporting of scoping reviews could be due to a lack of guidance or understanding about what consultation requires and the subsequent benefits. Knowledge user engagement in evidence synthesis, including consultation approaches, has many associated benefits, including improved relevance of the research and better dissemination and implementation of research findings. Scoping reviews, however, have not been specifically focused on in terms of research into knowledge user consultation and evidence syntheses. In this paper, we will present JBI's guidance for knowledge user engagement in scoping reviews based on the expert opinion of the JBI Scoping Review Methodology Group. We offer specific guidance on how this can occur and provide information regarding how to report and evaluate knowledge user engagement within scoping reviews. We believe that scoping review authors should embed knowledge user engagement into all scoping reviews and strive towards a co-creation model.


Assuntos
Encaminhamento e Consulta , Relatório de Pesquisa
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