A digital map of systematic reviews on non-pharmacological interventions to inform policy making in infectious disease control
Background: The COVID-19 pandemic accentuated the need for comprehensive evidence synthesis to guide decisions regarding infection disease control and preparedness. In Sweden, an investigator was tasked by the government with reviewing the Infection Control Act and analyzing the need for new regulations for future pandemics, with special considerations to measures that were effective during the COVID-19 pandemic. Against this background, SBU was requested to provide support to the investigator.
Objectives: To facilitate policymaking by conducting an overview of systematic reviews of nonpharmacological interventions (NPIs) and present the results in an interactive, user-friendly format.
Methods: A PICO was formulated comprising 10 NPIs used to prevent the spread of infections during outbreaks of COVID-19, SARS, MERS, Influenza and Ebola. A structured literature search for systematic reviews was conducted in Medline and Scopus. Eligible reviews were assessed for risk of bias using the AMSTAR checklist. The reviews were mapped according to risk of bias level and type of interventions and infections targeted and incorporated in a digital map.
Results: Seventy-eight systematic reviews were identified and included in the map. Of those, 43 were assessed as having high risk of bias and 35 as having low to moderate risk of bias. Most reviews focused on the effectiveness of various physical distance interventions or the effectiveness of facemasks. The vast majority of reviews and primary studies were conducted during the COVID-19 pandemic. The digital map facilitated navigation among the reviews and was used to support the legislative process.
Conclusions: Digital maps may be a useful tool to present and visualize available evidence and evidence gaps in an intuitive and interactive format that facilitates navigation. They can aid decision-making in complex fields such as public health measures, where it is challenging but important to identify and take into account the best available evidence of potential benefits and harms.
Patient, public and/or healthcare consumer involvement: Not applicable.