Epistemonikos Evidence Synthesis Project (Epistemonikos-ESP) is a collaborative initiative established in 2012 with the objective of collecting, organising and comparing all of the relevant research evidence for health decision-making, through a friendly, multilingual interface.
To collect all the evidence: Epistemonikos database
The first stage of the project aims to collect all of the evidence relevant for health decision-making into a single database: Epistemonikos database (1).
This stage is complete for systematic reviews (i.e. it is the largest database of systematic reviews relevant for decision-making in the world), but still in process for other types of articles. You can read about the methods here, and you can see an updated report of how many systematic reviews have been collected here.
To organise all the evidence: L·OVE
The second stage is to organise all the contents into the different questions they aim to answer. We follow the PICO format, the Evidence-based Medicine model for framing a question. PICO elements include: Problem/Patient/Population, Intervention, Comparison, Outcome.
We have created a platform called Living OVerviews of the Evidence (L·OVE) to display and navigate all the questions for a given topic (e.g. a specific disease), and all the existing evidence for those questions. If you want to know more about L·OVE, click here: love.epistemonikos.org
To compare all the evidence: Matrices, FRISBEEs and COVERs
The amount of research evidence is growing very fast, so there is usually tens or hundreds of articles relevant for a specific question. Indeed, there are usually several systematic reviews (i.e. the ‘best evidence’), commonly reaching to different conclusions.
The Matrix of Evidence (2) is a tool in Epistemonikos database that allows to compare different systematic reviews for the same question.You can read more about the matrix here.
We have designed methods to synthesise the ‘body of evidence’ for a specific PICO question in Epistemonikos (i.e. all the evidence in a matrix of evidence), so clinicians or other decision-makers can make sense of it – Living FRISBEEs (3) or researchers can advance the science in the particular question – Living COVERs.
Living FRISBEEs stands for Living Friendly Summaries of the Body of Evidence Using Epistemonikos, and are published in Spanish and English in Medwave. This journal was selected for being the only journal, as far as we know, that is agile, bilingual (i.e. Spanish-English) and open access. Medwave and Epistemonikos have been working together since 2014 to improve the quality, efficiency and usefulness of FRISBEEs, and to make them accessible to more decision-makers.
Living COVER stands for Living Comparison of OVErlapping Reviews, and publication will start by the end of 2017.
Evidence production and knowledge translation: Beyond Epistemonikos-ESP
Unfortunately, after the huge effort of collecting, organising and comparing all the existing evidence for a given question, often the conclusion is ‘there is no reliable evidence’. Sometimes there are no good guidelines, good systematic reviews or good primary studies.
The objective of Epistemonikos it to partner with organisations producing, translating or disseminating health evidence in order to contribute to their work.
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REFERENCES
- Rada G, Perez D, Capurro D. Epistemonikos: a free, relational, collaborative, multilingual database of health evidence. Studies in health technology and informatics. 2013;192:486-90
- Rada G, Neumann I, Cerda J. A new way to find evidence quickly and efficiently. Medwave 2014 Oct;14(10):e6044 doi: 10.5867/medwave.2014.10.6044 link
- Rada G, Bachelet VC. Epistemonikos summaries in Medwave: reliable and user-friendly evidence that is here to stay. Medwave. 2015 Aug 26;15(7):e6232. doi: 10.5867/medwave.2015.6232 link
