Analytic Framework [PDF - 68 KB]
When starting an effectiveness review, the systematic review team develops an analytic framework. The analytic framework illustrates how the intervention approach is thought to affect public health. It guides the search for evidence and may be used to summarize the evidence collected. The analytic framework often includes intermediate outcomes, potential effect modifiers, potential harms, and potential additional benefits.
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The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).
Dolan N, Ng J, Martin G, Robinson J, Rademaker A. Effectiveness of a skin cancer control educational intervention for internal medicine housestaff and attending physicians.Journal of General Internal Medicine 1997;12: 531-6.
Gerbert B, Wolff M, Tshcann J, McPhee S, Caspers N, Martin M, Saulovich A. Activating patients to practice skin cancer prevention: Response to mailed materials from physicians versus HMOs. American Journal of Preventive Medicine 1997;13: 214-20.
Gooderham M, Guenther L. Impact of a sun awareness curriculum on medical students’ knowledge, attitudes and behavior. Journal of Cutaneous Medicine and Surgery 1999;3:182-7.
Harris J. Can internet based continuing medical education improve physicians’ skin cancer knowledge and skills? Journal of General Internal Medicine 2001;16:50-6.
Harris J, Salasche S, Harris R. Using the internet to teach melanoma management guidelines to primary care physicians. Journal of Evaluation in Clinical Practices 1999;5:199-211.
Johnson E., Lookingbill D. Sunscreen use and sun exposure. Archives of Dermatology 1984;120:727-31.
Liu K, Barankin B, Howard J, Guenther L. One-year follow-up on the impact of a sun awareness curriculum on medical students’ knowledge, attitudes and behaviors. Journal of Cutaneous Medicine and Surgery 2001;5:193-200.
Mayer J, Eckhardt L, Stepanski B, Sallis J, Elder J, Slymen D, Creeh L, Graf G, Palmer R, Rosenberg C, Souvignier S. Promoting skin cancer prevention counseling by pharmacists. American Journal of Public Health 1998;88(7):1096-9.
Mayer J, Slymen D; Eckhardt L, Rosenberg C, Stepanski B, Creech L, Palmer. Skin cancer prevention counseling by pharmacists: Specific outcomes of an intervention trial. Cancer Detection & Prevention 1998;22:367-75.
McCormick L, Masse L, Cummings, Burke C. Evaluation of a skin cancer prevention module for nurses: Change in knowledge, self-efficacy and attitudes. American Journal of Health Promotion 1999;13:282-9.
Mikkileni R, Weinstock M, Goldstein M, Dube C, Rossi J. Impact of the basic skin cancer triage curriculum on providers skin cancer control practices. Journal of General Internal Medicine 2000;16:302-7.
Palmer R, Mayer J, Eckhardt L, Sallis J. Promoting sunscreen in a community drugstore. American Journal of Public Health 1998;88:681.
The following search strategy was used for the following reviews of interventions to prevent skin cancer: Community-Wide, Mass Media Campaigns (archived); Community-Wide, Multicomponent Interventions (archived); Education and Policy Approaches for Healthcare Settings and Providers; Education and Policy Approaches in Child Care Centers (archived); Education and Policy Approaches in Primary School Settings (archived); Education and Policy Approaches in Secondary Schools and Colleges (archived); Education and Policy Approaches in Outdoor Occupational Settings (archived); Education and Policy Approaches in Outdoor Recreational Settings (archived); Interventions Targeting Children’s Parents and Caregivers.
Electronic searches for literature were conducted in MEDLINE, PsycINFO, and CINAHL (nursing and allied health). The team also reviewed the references listed in all retrieved articles, and consulted with experts on the systematic review development team and elsewhere, including seeking published and unpublished articles in a sun protection listserve sponsored by the Environmental Protection Agency. The team included journal articles and governmental reports. The initial literature search on the topic was conducted in 1999, and the search was updated monthly until June 2000.
To be included, identified studies had to:
- Evaluate a specified population-based intervention for the prevention of skin cancer
- Be published in English from 1966 to June 2000
- Involve primary prevention of skin cancer (i.e., studies promoting screening were excluded because the effectiveness of screening was uncertain according to the USPSTF (see www.ahrq.gov/clinic/uspstf/uspsskca.htm)
- Evaluate effectiveness and assess at least one of the outcomes specified on the team’s analytic frameworks and/or provide information on one or more of the following domains: applicability, other effects (i.e., harms or side effects), economic evaluation, or barriers to intervention implementation
- Be conducted in an established market economy*
- Be a primary study rather than, for example, a guideline or review
Studies of effectiveness or applicability also required that the study compare a group of people who had been exposed to the intervention with a group of people who had not been exposed or who had been less exposed. (The comparisons could be concurrent or in the same group over time. Studies in the other domains could be with or without a comparison.)
1 skin neoplasms/or skin cancer.tw.
3 carcinoma, basal cell/or carcinoma, squamous cell/
4 nevus/or nevi.tw.
6 actinic keratoses.tw.
7 (sun damage or photodamage).tw. or skin aging/
8 solar keratoses.tw.
9 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8
10 primary prevention/or prevention.mp. [mp _title, abstract, registry number word, mesh subject heading]
12 knowledge/or knowledge, attitudes, practice/or knowledge.mp. [mp _ title, abstract, registry number word, mesh subject heading]
13 awareness/or awareness.mp. [mp _ title, abstract, registry number word, mesh subject heading]
14 (attitude or attitude or attitudes).mp. [mp _ title, abstract, registry number word, mesh subject heading]
15 public policy/or policy.mp. [mp _ title, abstract, registry number word, mesh subject heading]
16 health promotion/or health education/
17 behavior/or behavior:.mp. [mp _ title, abstract, registry number word, mesh subject heading]
18 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17
19 9 and 18
20 19 not screen:.tw,hw.
21 19 and screen:.tw,hw. and primary prevention.mp. [mp _ title; abstract, registry number word, mesh subject heading]
22 20 or 21
23 (sunburn: or suntan: or tanning).mp. [mp _ title, abstract, registry number word, mesh subject heading]
24 ultraviolet rays/or ultraviolet radiation.mp. [mp _title, abstract, registry number word, mesh subject heading]
25 (sun exposur: or sun protect: or sun safety or solar protect: or solar exposur:).mp. [mp _ title, abstract, registry number word, mesh subject
26 sunlight/or protective clothing/or protective clothing.mp. [mp _ title, abstract, registry number word, mesh subject heading]
27 sunscreening agents/
28 23 or 24 or 25 or 26 or 27
29 18 and 28
30 29 not screen:.tw,hw.
31 29 and screen:.tw,hw. and primary prevention.mp. [mp _ title, abstract, registry number word, mesh subject heading]
32 30 or 31
33 22 or 32
34 limit 33 to English language
35 limit 34 to human