Conducting and Disseminating Epidemiological Systematic Reviews in Latin America and the Caribbean: Pitfalls and Lessons Learned.

Objectives: To describe the experience, pitfalls, and lessons learned in conducting and disseminating epidemiological systematic reviews (SRs) in Latin America and the Caribbean between 2007 and 2016.

Methods: We used a mixed-methods approach, including a descriptive cross-sectional study and a qualitative study of pitfalls and lessons learned. The following end points were analyzed: number of primary research studies included, country of origin, study design, risk of bias, citations in social media, number of researchers and experts involved, and time devoted by them to conduct SRs. Data for the qualitative study were collected through sessions with multiprofessional focus groups of the reviewers' core team held from February to March 2016. We performed a thematic analysis of the following domains: sources of information, evidence quantity and quality, statistical analysis, and dissemination of findings in both academic and social media.

Results: A total of 19 SRs were produced, including 1016 primary research studies. Brazil (35%) and Argentina (19%) contributed the largest number of studies. The most frequent design was cross-sectional (35%). Only 27% of the studies included in the SRs were judged as having a low risk of bias. We identified key challenges at different stages of the process. We found substantial difficulties in all domains derived from the thematic analysis and proposed potential solutions for each of them.

Conclusions: There are large gaps in epidemiological evidence from primary research, particularly from population-based studies. Special approaches are needed to identify, assess, synthesize, interpret, and disseminate epidemiological evidence from Latin America and the Caribbean.