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.
- Differences between systematic reviews and health technology assessments: a trade-off between the ideals of scientific rigor and the realities of policy making. Rotstein D et al. Int J Technol Assess Health Care. 2004 Spring;20(2):177-83.
- Rapid versus full systematic reviews: an inventory of current methods and practice in Health Technology Assessment. ASERNIP-S Report No. 60. 2007
- Health technology appraisal of interventional procedures: comparison of rapid and slow methods. Warren. J Health Serv Res Policy July 2007 12:142—146.
- Rapid versus full systematic reviews: validity in clinical practice? Watt et al. Anz j. Surg. 2008; 78: 1037–1040
- Rapid reviews versus full systematic reviews: an inventory of current methods and practice in health technology assessment. Watt A et al. Int J Technol Assess Health Care. 2008 Spring;24(2):133-9.
- Expediting systematic reviews: methods and implications of rapid reviews. Ganann et al. Implementation Science 2010, 5:56
- Evidence summaries: the evolution of a rapid review approach. Khangura et al. Systematic Reviews 2012, 1:10
- Rapid Evidence Assessment Toolkit index (Civil Service)
- Translating research evidence into action in daily practice. Otolaryngol Head Neck Surg. 2010 Jan;142(1):29-30.
- Evidence and guidelines in otorhinolaryngology: the merits of evidence-based case reports
April 16, 2012 at 8:47 pm
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
(not OA, but let me know if you'd like to see it)
also see this PhD Thesis (esp. Discussion):
At our university/medical school, 6th year medical students learn to write these EBCRs to answer clinical questions, and about 300 are produced yearly.