Piloting the novel Evidence Synthesis Equity Companion (ESEC) tool

The need for greater evidence on equity-denied population groups continues to be recognized across public health, epidemiology, and community medicine. Despite a number of existing frameworks and tools on the inclusion of equity considerations in evidence syntheses, there was a gap in tools providing step-wise guidance and facilitating the documentation of the process.

We adapted the Equity Checklist for Health Technology Assessment (ECHTA) to the more specific steps of an evidence synthesis. We complemented the guidance provided from seminal resources with articles from a comprehensive literature search and input from expert methodologists. We piloted the tool with a rapid review on substance-related mortality across racialized and ethic groups. We reported on the methodological changes following the use of the tool and the limitations we have observed.

The Evidence Synthesis Equity Companion (ESEC) tool provides guidance and structure to considering equity and the methods to use at each step of an evidence synthesis. It allows review authors to transparently document their process and explicitly highlight its limitations. During the pilot, using the ESEC tool resulted in enhanced approaches to answer the equity-focused review question. Certain limitations remain with the tools, notably a more thorough guidance development for incorporating equity in the knowledge translation process.

The ESEC tool provides structured guidance, supporting the incorporation of equity considerations throughout the evidence synthesis process. The pilot demonstrated its benefits both for the methods used and the evidence uncovered. Additionally, the process was valuable to the review team. Using the tool in different types of evidence syntheses will allow for greater insight into its value-added.