An emerging digital and trustworthy evidence ecosystem for malaria: Rapid creation and dissemination of trustworthy recommendations in Africa




Long oral session 13: Rapid guideline development


Thursday 14 September 2017 - 14:00 to 15:30


All authors in correct order:

Okwen P1, Siemieniuk R2, Brandt L3, Lytvyn L4, Guyatt G2, MacDonald H5, Agoritsas T6, Vandvik PO3
1 Effective Basic Services Africa, Cameroon
2 McMaster University, Canada
3 Innlandet Hospital Trust-division Gjøvik, Norway
4 Oslo University Hospital, Norway
5 The British Medical Journal, United Kingdom
6 University Hospitals Geneva, Switzerland
Presenting author and contact person

Presenting author:

Patrick Okwen

Contact person:

Abstract text
BACKGROUND: Treatment of HIV represents a global challenge but also an opportunity to explore how innovations in an emerging Digital and Trustworthy Evidence Ecosystem could make a difference in Africa and other Low and Middle Income Country (LMIC) settings.

OBJECTIVES: We aim to respond to new evidence for treatment of HIV with the rapid creation, dissemination and implementation of trustworthy recommendations at the point of care in Africa.

METHODS: Figure 1 visualizes the Digital and Trustworthy Evidence Ecosystem for this case study. Here, evidence producers have published a trial on pregnant women with HIV. This potentially practice-changing the new evidence was presented to a collaborative network of clinicians, patients, researchers and experts in systematic review and guideline development (Rapid Recommendations panel). The panel created and published trustworthy recommendations, evidence summaries and decision aids within 90 days, following well defined methods and processes (BMJ Rapid Recommendations). Dissemination was performed through the BMJ in novel publication formats and through in digitally structured multi-layered presentation formats available "online and offline anywhere, anytime on all devices". Selected practices in Africa then worked to actively implement the trustworthy recommendations, followed by evaluation and improvement of care, also to study barriers and facilitators of the evidence ecosystem in an LMIC setting.

RESULTS: We will present the BMJ Rapid Recommendations for HIV within the Evidence Ecosystem, including barriers and facilitators for active implementation and evaluation of delivered care in Africa.

CONCLUSIONS: The Evidence Ecosystem for HIV exemplifies opportunities for closing the loop between new evidence and improved care but also remaining challenges, some likely to be particular for LMIC settings.