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Table 1 The need for contextualizing evidence

From: The TRANSFER Approach for assessing the transferability of systematic review findings

Scenario: You are a systematic review author commissioned by a European government agency to conduct a review on the effectiveness of an intervention to reduce homelessness and improve number of days in stable housing for people who have been homeless. You identify, appraise and synthesise the evidence and use the GRADE approach to assess the certainty of the evidence, including an assessment of the directness of the evidence. At the end of the systematic review, you present the results to the commissioner and are faced with the criticism that the results will not transfer to their context because all of the included primary studies were conducted in the USA. Through multiple rounds of dialogue with stakeholders you discover that key contextual factors (for example, how long participants are homeless before participating in an intervention) are important to the success and viability of intervention in the end users’ context, and that the review has not considered these factors adequately. The end users therefore perceive the results of the review as not as useful to their decision making process as they anticipated.