# Methods of Engaging Interest‐Holders in Healthcare Evidence Syntheses: A Scoping Review

## TL;DR

This paper updates a review on how to involve stakeholders in healthcare evidence syntheses, finding that patients and professionals are often engaged, but methods vary widely.

## Contribution

The study provides an updated overview of stakeholder engagement methods in evidence syntheses and proposes a decision tool and recommendations for future practice.

## Key findings

- 302 publications on stakeholder engagement in evidence syntheses were identified since 2016, with most from the UK, US, Canada, and Australia.
- 51 papers provided comprehensive descriptions of engagement methods, often involving patients and professionals in multiple stages of the process.
- A decision tool was developed to guide stakeholder engagement strategies based on identified patterns and approaches.

## Abstract

Engaging interest‐holders in health care evidence syntheses may make evidence syntheses more relevant, useful, and accessible. However, the best way(s) to engage interest‐holders within the evidence synthesis process remain unknown. A previous scoping review collated 291 publications that reported interest‐holder engagement in evidence syntheses, but conclusions were limited due to poor reporting. In the present scoping review, our aim was to identify and collate up‐to‐date publications focussed on interest‐holder engagement in healthcare evidence syntheses, describe reported methods of engagement, and compare the results with those from the previous review.

We updated a scoping review, following JBI guidance, using a pre‐published protocol that defined all key terminology in this field. We systematically searched five electronic databases (MEDLINE, CINAHL, EMBASE, PsycInfo, and SCOPUS). Searches were conducted from January 2016 to February 2024. Records were imported into Covidence and screened by pairs of independent reviewers, including any publications that reported engagement of interest‐holders in evidence syntheses. We extracted and coded key data relating to the evidence synthesis topic and ACTIVE framework domains (who was engaged, when, and in what way). Two reviewers independently made a judgment of the comprehensiveness of the description of methods of engagement, using a “traffic‐light” system, coding evidence syntheses with comprehensive descriptions as “green,” brief or partial descriptions as “amber,” and those with few details as “red”; disagreements were resolved through discussion. Additional detailed data relating to the engagement methods were extracted from “green” evidence syntheses. Any disagreements were resolved through discussion. Data were synthesized within tables, and narrative summaries were written to provide an overview of key methods of engaging interest‐holders within the identified evidence syntheses.

We identified 302 publications published since the previous review. Most (272/302, 90%) reported interest‐holder engagement in a single evidence synthesis; of these, 74% (200/272) engaged patients and/or their carers, while 17% (46/272) engaged other interest‐holders only, and the remainder (26/272, 9.6%) was unclear. Over three‐quarters of the evidence syntheses were conducted either in the United Kingdom, United States, Canada, or Australia (215/272, 79%). Most often (113/272, 42%), interest‐holders were engaged at both the initial (scope and question setting) and final (interpretation of results) review stages (referred to as a “top and tail” approach). Nineteen percent (51/272) were judged to provide a comprehensive (“green”) description of one or more method(s) or approach(es) to engagement in an evidence synthesis, enabling detailed data extraction and description. Most: engaged patients/public members and other interest‐holder groups (30/51, 59%); used a “closed” recruitment strategy (30/51, 59%); engaged interest‐holders during the stage of interpretation of findings (39/51, 76%); had at least one interest‐holder as a co‐author (27/51, 52%). Interest‐holders generally attended meetings at which no formal methods of engagement were used. It was common to engage interest‐holders in multiple activities throughout the review process.

Our international team from the MuSE consortium has updated a previous scoping review, compiling the latest evidence on interest‐holder engagement in evidence syntheses. We collated 302 publications and described the methods of interest‐holder engagement reported in 51 evidence syntheses that we judged provided the most comprehensive information. Interest‐holders have been involved at all stages of the process, using a wide range of engagement approaches, but with no clear patterns linked to the type or focus of evidence syntheses. Most commonly, patients/public and professional interest‐holders were both engaged, but around one‐quarter of our examples only engaged patients/public members, and a small number only engaged professional interest‐holders. We identified some distinct engagement strategies and have used these to inform a potential decision tool to support the selection of engagement strategies. We propose recommendations in relation to the conduct and reporting of interest‐holder engagement in evidence syntheses and future research to advance this field.

In health care, evidence syntheses bring together the results of research studies to inform clinical practice and policy. Engagement of interest‐holders (including patients, public, carers, health professionals, policy makers, and others) in evidence syntheses is thought to make evidence syntheses more useful and usable, but the best ways of engaging interest‐holders are not known. We used recognized methods for conducting high‐quality research to bring together evidence syntheses that report interest‐holders' engagement. We described all aspects of engagement. We found 302 relevant papers that had been published since 2016 (a previous study brought together papers published before 2016). Most papers were from the United Kingdom, the United States, Canada, or Australia. Ninety percent of the papers reported interest‐holder engagement in a single evidence synthesis. In three‐quarters of these patients and carers were engaged. Fifty‐one papers gave a comprehensive description of interest‐holder engagement, and we explored these in more detail. This helped us to identify various ways of engaging interest‐holders. We brought these different ways together and made a diagram to help people make decisions about how they could plan interest‐holder engagement in a future evidence synthesis. Using our findings, we also made some recommendations to help improve future interest‐holder engagement in evidence syntheses.