A context-specific conceptual framework of evidence synthesis to improve childhood cancer health outcomes and resource use in Egypt: Using real-world data and addressing the implementation gaps.

Introduction: Given the large numbers of children with cancer in Egypt, the limited resources, and inferior survival outcomes, there is a need to better target resources to improve outcomes efficiently based on evidence. Nevertheless, there is a gap in knowledge about childhood cancer health outcomes and resource use in Egypt. This commentary presents a "context-specific" conceptual framework of evidence synthesis to improve childhood cancer health outcomes and resource use in a resource-limited setting in Egypt, using real-world data and addressing the implementation gaps. Methods: Real-world data is defined as data relating to health status and/or the delivery of health services routinely collected from various sources outside the contexts of randomized controlled trials that can be used to conduct prospective/retrospective observational research studies. Results: To better address this context-specific clinical problem, the conceptual framework of evidence synthesis proposes to generate three types of evidence using hybrid research methods; (1) Real-world evidence (obtained from observational studies based on routinely collected data from local context); (2) systematic evidence from the literature (systematic review); and (3) qualitative evidence based on experts' opinions in the local setting (interview study). Generating evidence from the three pillars altogether makes for a stronger approach to better research and tackle the local problem in this specific resource-limited context, and address the implementation gaps. Conclusions: This framework serves as a methodological roadmap to generate relevant evidence in similar resource-limited contexts in low- and middle-income countries, where there is a paucity of published studies in the literature about childhood cancer survival outcomes and resource use.