BackgroundResearch conducted on conditions responsible for the greatest disease burden should be given the highest priority, particularly in resource-limited settings. The present study aimed to assess the research output in relation to disease burden in Palestine and to identify the conditions which are under- or over-investigated, if any.MethodsWe searched PubMed and Scopus for reports of original research relevant to human health or healthcare authored by researchers affiliated with Palestinian institutions and published between January 2000 and December 2015. We categorised the condition studied in included articles using the Global Burden of Disease (GBD) taxonomy. Data regarding burden of disease (percentage of deaths and disability-adjusted life years (DALYs)) was obtained from the Palestine profile in the GBD study. We examined the degree of discordance between the observed number of published articles for each disease/condition with the expected number based on the proportion of disease burden of that disease/condition.ResultsOur search identified 2469 potentially relevant records, from which 1650 were excluded following the screening of titles and abstracts. Of the remaining 819 full-text articles, we included 511 in our review. Communicable (infectious) diseases (n = 103; 20%) was the condition with the highest number of published studies. However, cancer (n = 15; 3%) and chronic respiratory diseases (n = 15; 3%) were the conditions with the lowest number of published studies. Research output was poorly associated with disease burden, irrespective of whether it was measured in terms of DALYs (rho = −0.116, P = 0.7) or death (rho = 0.217, P = 0.5). Cardiovascular disease, cancer, and maternal and neonatal deaths accounted for more than two-thirds of the total deaths in Palestine (67%), but were infrequently addressed (23%) in published articles.ConclusionsThere is evidence of research waste measured by a mismatch between the health burden of certain diseases/conditions and the number of published research reports on those diseases/conditions in Palestine. A national research priority-setting agenda should be developed to meet the local community’s need for quality evidence to implement independent and informed health policies.

Post-operative pain exacts a high toll from patients, families, healthcare professionals and healthcare systems worldwide. PAIN-OUT is a research project funded by the European Union's 7th Framework Program designed to develop effective, evidence-based approaches to improve pain management after surgery, including creating a registry for feedback, benchmarking and decision support. In preparation for PAIN-OUT, we conducted a pilot study to evaluate the feasibility of international data collection with feedback to participating sites. Adult orthopaedic or general surgery patients consented to participate between May and October 2008 at 14 collaborating hospitals in 13 countries. Project staff collected patient-reported outcomes and process data from 688 patients and entered the data into an online database. Project staff in 10 institutions met the enrolment criteria of collecting data from at least 50 patients. The completeness and quality of the data, as assessed by rate of missing data, were acceptable; only 2% of process data and 0.06% of patient-reported outcome data were missing. Participating institutions received access to select items as Web-based feedback comparing their outcomes to those of the other sites, presented anonymously. We achieved proof of concept because staff and patients in all 14 sites cooperated well despite marked differences in cultures, nationalities and languages, and a central database management team was able to provide valuable feedback to all.

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Background Overweight and obesity are increasing at an alarming rate in developed countries and developing countries like Palestine. Obesity (body mass index [BMI]30) and overweight (BMI 25•0−29•9) predispose to several non-communicable diseases (NCDs) such as diabetes, hypertension, and cardiovascular diseases. Obesity prevalence studies in different age groups and locations across Palestine are very varied in their methods, participants, settings, or results. We aimed to assess the prevalence of obesity and overweight among children (18 years of age and under), adults (over 18 years of age), and people with NCDs in Palestine. Methods We conducted a systematic search and review of literature in PubMed, Embase, Scopus, CINAHL, and the Cochrane Library (from inception to Dec 3, 2016) for articles reporting obesity or overweight prevalence among Palestinians. We included all original, population-based studies, irrespective of their design or publication status, language, or age of participants. Studies were included if they used BMI, waist circumference, or waist−hip ratio as their measurement tool. Two authors independently screened titles, abstracts, and full texts for eligibility, then extracted relevant data and assessed the risk of bias. We pooled prevalence estimates of obesity and overweight using random effect models and reported the prevalence (with 95% CI) for children, adults, and people with NCDs separately. Findings Of 773 citations retrieved, we included 38 eligible articles. The pooled prevalences of obesity and overweight were 6% (range 4−10%; I²=98%) and 15% (13−17%; I²=92%) in children; 18% (11−29%; I²=98%) and 30% (24−38%; I²=97%) in adults; and 49% (35−64%; I²=98%) and 40% (31−50%; I²=96%) in people with NCDs. All studies had a moderate to high risk of bias, especially selection bias. Most studies had incomplete reporting of STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist items, especially for source of bias (95%), study limitations (60%), and funding (80%). Interpretation The prevalences of obesity and overweight in Palestine are high compared with those of some other developing nations, such as Tunisia, especially among adults and people with NCDs. However, the results should be interpreted cautiously in light of the high heterogeneity encountered in most studies. Our findings suggest that strategies are required to reduce obesity, and future research needs to identify the most effective interventions for combatting obesity in Palestine. Funding None. Contributors KE designed the study and protocol, developed the data collection sheet, collected data, and wrote and reviewed the Abstract. LE designed the study, developed the data collection sheet, and interpreted and reviewed the Abstract). All authors have seen and approved the final version of the abstract for publication. Declaration of interests We declare no competing interests.