Background: Evidence-based insurance medicine (IM) facilitates the systematic use of research evidence to inform social and medical decisions in the context of insurance coverage. Despite obvious information needs, access to relevant research is a key barrier that prevents evidence-informed decision-making in IM.
Objective: To design and pilot a database for research evidence with a focus on core topics of IM that is straightforward to search, easy to access and relevant to users.
Methods: Our methodology uses 6 steps: a) Identify the user needs; b) Set up a process to identify relevant evidence (search filters, suitable databases, screening, selection criteria); c) Develop a concept for assessing the quality of included studies; d) Develop a concept for indexing; e) Work out a process for feeding the database, including links to Cochrane reviews relevant to IM; and, f) Perform user testing and pilot functionality of the website. EUMASS core activities of IM (sickleave certification, assessment of work disability, return-to-work, assessment of causality, participation, health care utilisation) serve as content framework; we cover assessment instruments and methodological issues.
Results: a) User needs: A heterogeneous spectrum of Swiss and German IM professionals identifed more than 200 PICO questions from their daily work which were analysed according to the EUMASS framework. We used the IM outcomes from Cochrane Insurance Medicine. When presenting the database concept during two international conferences (EUMASS 2016; ICLAM 2016), it was well received and confirmed the perceived gap of access to IM evidence. b) Identify evidence: We used our collection of relevant systematic reviews (n > 100) (insuremed.cochrane.org/evidence) for developing and validating search filters. We developed strategies and the logistics for efficient screening and selection of citations. c) Quality assessment: We identify quality criteria for different study types, pilot them and check for reliability. d) Indexing: First, we determine specific key words and a system for tagging. e) Feeding the database: In collaboration with HIRU, Health Information Research Unit at McMaster Univ.