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Western Libraries Undergraduate Research Awards (WLURAs)

Abstract

Health resources are limited; therefore, policy makers must make difficult decisions about how to allocate these resources. Equity-efficiency trade-off studies use various methods to elicit individuals’ health allocation preferences, with the goal of informing health policy. These methods have inherent psychometric properties, such as validity and reliability. This systematic review sought to determine whether and how equity-efficiency trade-off studies assess psychometric properties. We used a validated systematic review methodology to screen records identified through database searching. Only 33 of the 115 included equity-efficiency trade-off studies assessed psychometric properties. Less than 15% of included studies assessed validity and less than 10% of studies assessed reliability, robustness, or framing effects. The results of this systematic review suggest that psychometric properties are undermeasured and underreported in the equity-efficiency trade-off literature. These findings have significant implications for health resource allocation decisions. Equity-efficiency trade-off studies should be interpreted and applied to high-impact policy decisions with caution. Moving forward, researchers should assess psychometric properties so that the results of their equity-efficiency trade-off studies can be confidently and effectively applied to health policy decisions.

How did you choose your research topic and/or design your research question? (200 words)

My Scholar's Electives research supervisor provided some background articles on equity-efficiency trade-off studies and psychometric properties and suggested that I do a systematic review on this topic. I accessed the recommended literature through the Western Libraries website and identified additional relevant reading through reference lists. Once I had familiarized myself with the literature, I began searching on Google Scholar to identify gaps in the literature. There was a paucity of relevant articles on Google Scholar, so I ran a preliminary MEDLINE search. I repeated the search strategy of a previously published systematic review of equity-efficiency trade-off studies and combined their search terms with terms related to psychometric properties. The MEDLINE search returned only 567 hits, fewer than my supervisor and I were expecting. I then read through some systematic and scoping reviews of equity-efficiency trade-off studies and discovered that none of them addressed psychometric properties. Subsequently, I identified a gap in the literature; there had been no published systematic reviews that addressed the psychometric properties of equity-efficiency trade-off studies. I then identified and developed my research question using the SPIDER systematic review question framework. The final question was: “Do equity-efficiency trade-off studies assess validity and reliability?”

How did you find library/archives services and resources for your research topic? (200 words)

I decided to search Ovid MEDLINE, Ovid EMBASE, and Web of Science as I felt they would provide results relevant to the discipline of health economics. I wanted to find all equity-efficiency trade-off studies, and then determine whether they assessed psychometric properties, so I decided not to include any terms related to psychometric properties in the search strategy. I designed the search strategy to capture health-related equity-efficiency trade-off studies by combining three major concepts: health AND preference elicitation study AND equity or equality. I identified terms for each of these concepts by consulting previously published systematic reviews of equity-efficiency trade-off studies. I used a combination of MeSH and Emtree subject headings with keywords, using the suffixes ‘.tw,kf.’ Helpful subject headings included “Resource Allocation,” “Health Priorities,” and “Choice Behavior.” I used wildcards in my keywords to ensure that I would capture varying spellings. The final search strategy was approximately 24 lines long, combined with Boolean operators. I validated the sensitivity of my search strategy by ensuring that it captured all or most of the studies that were included in previously published systematic reviews. The full search strategies for the three databases can be found in Appendix A of my paper.

What library/archives services and resources did you use to perform your research? (200 words)

Prior to starting my systematic review, I reviewed the Western Libraries’ Guide to Systematic and Scoping Reviews. This webpage gave me the confidence to start my review knowing I had a good grasp of the fundamental methodological principles. Another library service I found especially helpful was the research consultation with a librarian. I met with Sam Vettraino at Taylor Library, who looked over my search strategy and told me that it was well-crafted and that I had made effective use of advanced searching techniques. This was reassuring, because the search strategy development process was quite challenging, as it was my first time crafting a search strategy by myself. Sam also provided me with general database searching tips and suggested which databases to use for my topic. She suggested Web of Science, which I previously had not considered. This tip was extremely helpful, because Web of Science ended up capturing many of the studies that were not captured in MEDLINE and EMBASE. Web of Science is now one of my favourite databases because of its friendly user interface. I did most of the research and writing for this project in the study spaces at Weldon Library.

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