Knowledge synthesis

The Knowledge Synthesis Program in the Mayo Clinic Kern Center for the Science of Health Care Delivery helps Mayo's clinical practice identify and examine existing knowledge to ensure that the best available evidence is applied to patient care. The program's work also helps identify gaps in knowledge or implementation that Mayo Clinic researchers can fill. It supports Mayo's ability to provide the best possible care for every patient.

Knowledge synthesis is a system of research methods within healthcare delivery science. It is a critical first step in knowledge translation. Knowledge synthesis consists of the basic steps of identifying evidence, assessing its value, and combining it to produce a brief summary that informs best practice. The Knowledge Synthesis Program has national and international expertise in conducting studies of the following designs:

  • Systematic reviews and meta-analysis.
  • Network meta-analysis.
  • Individual participant data meta-analysis.
  • Meta-narrative and qualitative synthesis.
  • Clinical practice guidelines.
  • Meta-epidemiology studies.
  • Critical appraisal and methodology development of clinical research.

The Knowledge Synthesis Program bolsters Mayo's ability to reliably provide high-quality care and outstanding patient experiences. The program team also supports governmental entities and professional societies. It helps them develop national and international clinical practice guidelines spanning various conditions, diseases and methods of healthcare delivery.

Focus areas

  • Providing stakeholders with the least biased, most precise and most applicable results by conducting systematic reviews and meta-analyses.
  • Helping professional organizations and medical societies develop clinical practice guidelines that combine research evidence with patients' values and preferences.
  • Conducting methodology research to advance the methods of translational research.
  • Creating future research agendas by identifying gaps in knowledge and producing evidence maps.
  • Ensuring that resources are not wasted on efforts to pursue research questions that have already been answered.
  • Advising Mayo Clinic researchers who are conducting original studies about design features and analytical approaches to implement in their studies. This helps them produce high-quality evidence that meets the needs of patients, clinicians and policymakers.

Projects

Evidence-Based Practice Center projects

A major activity of the Knowledge Synthesis Program is to oversee Mayo Clinic's Evidence-Based Practice Center. The Evidence-Based Practice Center has supported numerous institutions, professional organizations and societies, including:

  • Centers for Disease Control and Prevention
  • Centers for Medicare & Medicaid Services
  • National Institutes of Health
  • Patient-Centered Outcomes Research Institute
  • World Health Organization

An example of this work was a comprehensive systematic review comparing the effectiveness, adverse events and cosmetic outcomes of partial-breast irradiation compared with whole-breast irradiation for women with early-stage breast cancer. Commissioned by the Agency for Healthcare Research and Quality, this study showed similar rates of in-breast recurrence, cancer-free and overall survival between both types of irradiation. However, receiving to only a portion of the breast led to less severe treatment side effects and less financial burden to patients.

Related publications:

Response to the COVID-19 pandemic

The Knowledge Synthesis Program developed a response to the pandemic within two weeks of the World Health Organization's declaration of a pandemic. The program team produced a framework for evidence synthesis to support decision-making of Mayo Clinic clinical practice. This included updating literature searches twice a week.

An example of the output of this framework was the development of rapid guidance about anticoagulation in COVID-19, published at a time of high uncertainty and sparse evidence. This guidance was spread widely through the AskMayoExpert COVID-19 Navigator. The navigator provides Mayo Clinic's consensus-based expert clinical recommendations, protocols and best practices for COVID-19 — and Mayo Clinic makes it available for clinicians everywhere.

The Knowledge Synthesis Program has since produced more than 50 publications related to the pandemic, including national and international guidelines and statements.

Related publications:

Methodology research and study design consultation

The Knowledge Synthesis Program conducts meta-epidemiological research to study various methodological and analytical approaches and improve future study design. Examples of these methodological studies include guides to analyze continuous outcomes in meta-analysis and to estimate risk difference, also called absolute risk reduction. Other examples include a tool to assess risk of bias in case studies and case reports and an approach to synthesis of noninferiority trials.

Program experts constantly appraise research and conduct methodology research. This allows them to provide consultative support and guidance to other health services researchers. One example of the many studies that the Knowledge Synthesis Program has supported includes a study examining gender disparities in hospitalized patients.

Related publications:

Living systematic reviews platform

The Knowledge Synthesis Program supported the development of a dynamic tool to help clinicians and researchers stay on top of rapidly evolving research findings. One example involved treatments for kidney cancer. The project team summarized the evidence. Then, they updated it constantly, using a variety of automated functions and displays that cater to the needs of different decision-makers. The team continues to refine the tool.

Related publication:

Contact

M. Hassan Murad, M.D.

Zhen Wang, Ph.D.