Monday, April 16, 2012

Rapid versus systematic reviews

While systematic reviews remain the gold standard for synthesising evidence, they are typically costly and take months and months.  In a healthcare setting, both time and money are under heavy restraint - so what are the options?

I have been undertaking rapid reviews (in the form of clinical Q&As) for nearly 15 years e.g. ATTRACT.  Me and my various teams have answered well over 10,000 questions - the majority taking less than 4 hours.  So, there are clear difference between what we do and what a systematic review does. I have typically justified my outputs by not claiming to do a systematic review but to be transparent about what we do and also, the hope, that we would do better than an individual clinician.  In addition we have published all our answers on the web and many have been viewed over 5,000 times - most pass without comment.  I feel moderately reassured by this post-publication 'peer review'.  In fact, we have only had one major alert where we clearly made a serious error.  It was around the time of the Cox-2 issues and we relied on pre-crisis documentation!

But, it'd be complacent to think our methods are perfect.  So, I recently asked the EBHC mail-list for any literature on the subject (rapid versus systematic reviews) and the results are below, if you know of any others then please let me know.

1 comment:

Bianca Kramer (@MsPhelps) said...

Evidence based case reports (EBCRs):
Translating research evidence into action in daily practice. Rovers M and Van der Heijden G. Otolaryngol. Head Neck Surg 2010: 142:29-30
PMID 20096219
(not OA, but let me know if you'd like to see it)

also see this PhD Thesis (esp. Discussion):
http://igitur-archive.library.uu.nl/dissertations/2012-0209-200346/UUindex.html

At our university/medical school, 6th year medical students learn to write these EBCRs to answer clinical questions, and about 300 are produced yearly.