A team of researchers at UCSF and the Kaiser Family Foundation has launched a new web portal this month that aims to answer that most practical of public health questions: What works?
James G. Kahn, MD, MPH
Think of it as Cliffs Notes for global health. The new website – Global Health Intervention Review (GHIR) – summarizes all of the interventions used to prevent and treat eight infectious diseases and other health conditions: Dengue fever, HIV/AIDS, malaria, TB, waterborne diarrhea, maternal hemorrhage, maternal sepsis and unintended pregnancy.
Want to know how effectively insecticides control malaria or Dengue fever? Can’t recall the key antibiotic regimens for tuberculosis? Need to find out which is more effective at reducing water-borne diarrhea: vaccines or clean water efforts? Need to know which forms of birth control work best in avoiding pregnancy?
The website answers those questions and more, said UCSF professor James G. Kahn, MD, MPH, who led the effort to compile the information behind it. Kahn is an expert in policy modeling in health care, cost-effectiveness analysis, and evidence-based medicine used to inform decision-making in public health and medicine.
The website is designed to help policy-makers and funders sort through the best available information on prevention and treatment, find which have the largest effects and best supporting evidence and invest wisely in them to reduce the risk of death and disease in the developing world.
“The science can get both overwhelming and complex – even experts are inundated by the number of reports out there,” said Kahn. “The point of the site is to make sure that the best available informationis actually available.”
The work started about three years ago when the Kaiser Family Foundation approached Kahn to create this “meta-systematic review” for the Kaiser Global Health web portal.
Based at the Philip R. Lee Institute for Health Policy Studies and in the Institute for Global Health, both at UCSF, the team included Elliot Marseille, Mohsen Malekinejad and Brian Harris. Together with Kahn, they identified all existing systematic reviews, extracted and synthesized their findings, and checked the work with experts .
According to Kahn, the team found the best source of consistent and complete information to be from the Cochrane Collaboration, the leading global organization that produces systematic reviews in health that has both a center that coordinates its work and an HIV review group at UCSF.
“Cochrane reviews were originally developed with an emphasis on using rigorous methods and minimizing conflicts of interest,” said Lisa Bero, PhD, who runs the San Francisco Branch of the United States Cochrane Center at UCSF. “The Cochrane Collaboration has been striving to cover more topics and make our reviews relevant for low resource settings, while still maintaining quality, so it is encouraging to see that our reviews were the best source for the GHIR.”
In addition to including background and epidemiology for each disease, the site lays out the strength of evidence for each intervention. According to Kahn, he and his colleagues are now designing a system that allows a user to interactively compare and combine intervention strategies in terms of effect on disease burden, cost and cost-effectiveness.