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de Andrade KRC, Carvalho VKDS, Silva RB, Luquine Junior CD, Farinasso CM, Oliveira CDF, Mascarenhas F, de Paula GAR, de Toledo IP, Marinho MAM, Wachira VK, Siqueira ADSE, Araújo DV, Sachetti CG, Rêgo DF. Evidence syntheses to support decision-making related to the Covid-19 pandemic. Rev Saude Publica 2024; 58:16. [PMID: 38716928 PMCID: PMC11037906 DOI: 10.11606/s1518-8787.2024058005226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 07/10/2023] [Indexed: 05/12/2024] Open
Abstract
The COVID-19 pandemic generated a large volume of scientific productions with different quality levels. The speed with which knowledge was produced and shared worldwide imposed on health management the challenge of seeking ways to identify the best available evidence to support its decisions. In response to this challenge, the Department of Science and Technology of the Brazilian Ministry of Health started offering a service to produce and provide scientific knowledge addressing priority public health issues in the pandemic scenario. Drug treatments, non-pharmacological measures, testing, reinfection and immunological response, immunization, pathophysiology, post-COVID syndrome and adverse events are among the topics covered. In this article, we discuss the strengths and lessons learned, as well as the challenges and perspectives that present a real example of how to offer the best scientific evidence in a timely manner in order to assist the decision-making process during a public health emergency.
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Affiliation(s)
- Keitty Regina Cordeiro de Andrade
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Viviane Karoline da Silva Carvalho
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Roberta Borges Silva
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Cézar D. Luquine Junior
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Cecília Menezes Farinasso
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Cintia de Freitas Oliveira
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Fabiana Mascarenhas
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Gabriel Antônio Rezende de Paula
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Isabela Porto de Toledo
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Marina Arruda Melo Marinho
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Virginia Kagure Wachira
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Alessandra de Sá Earp Siqueira
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Denizar Vianna Araújo
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Camile Giaretta Sachetti
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
| | - Daniela Fortunato Rêgo
- Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em SaúdeDepartamento de Ciência e TecnologiaBrasíliaDFBrasilMinistério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Ciência e Tecnologia. Brasília, DF, Brasil
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Floriano FR, Boeira L, Biella CDA, Pereira VC, Carvalho M, Barreto JOM, Oliveira SMDVLD. Strategies to approach the judicialization of health in Brazil: an evidence brief. CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023281.09132022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract This article seeks to identify and discuss evidence-informed options to address the judicialization of health. The Supporting Policy Relevant Reviews and Trials Tools were used to define the problem and the search strategy, which was carried out in the following databases: PubMed, Health Systems Evidence, Campbell, Cochrane Collaboration, Rx for Change Database, and PDQ-Evidence. Selection and assessment of methodological quality was performed by two independent reviewers. The results were presented in a narrative synthesis. This study selected 19 systematic reviews that pointed out four strategies to address the judicialization of health in Brazil: 1) Rapid response service, 2) Continuous education program, 3) Mediation service between the parties involved, and 4) Adoption of a computer-based, online decision-making support tool and patient-mediated interventions. This study therefore presented and characterized four options that can be considered to address the judicialization of health. The implementation of these options must ensure the participation of different actors, reflecting on different contexts and the impact on the health system. The availability of human and financial resources and the training of teams are critical points for the successful implementation of the options.
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Floriano FR, Boeira L, Biella CDA, Pereira VC, Carvalho M, Barreto JOM, Oliveira SMDVLD. Strategies to approach the judicialization of health in Brazil: an evidence brief. CIENCIA & SAUDE COLETIVA 2023; 28:181-196. [PMID: 36629563 DOI: 10.1590/1413-81232023281.09132022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/12/2022] [Indexed: 01/11/2023] Open
Abstract
This article seeks to identify and discuss evidence-informed options to address the judicialization of health. The Supporting Policy Relevant Reviews and Trials Tools were used to define the problem and the search strategy, which was carried out in the following databases: PubMed, Health Systems Evidence, Campbell, Cochrane Collaboration, Rx for Change Database, and PDQ-Evidence. Selection and assessment of methodological quality was performed by two independent reviewers. The results were presented in a narrative synthesis. This study selected 19 systematic reviews that pointed out four strategies to address the judicialization of health in Brazil: 1) Rapid response service, 2) Continuous education program, 3) Mediation service between the parties involved, and 4) Adoption of a computer-based, online decision-making support tool and patient-mediated interventions. This study therefore presented and characterized four options that can be considered to address the judicialization of health. The implementation of these options must ensure the participation of different actors, reflecting on different contexts and the impact on the health system. The availability of human and financial resources and the training of teams are critical points for the successful implementation of the options.
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Affiliation(s)
- Fabiana Raynal Floriano
- Departamento de Gestão e Incorporação de Tecnologias em Saúde, Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde, Ministério da Saúde. Zona Cívico-Administrativa. 70058-900 Brasília DF Brasil.
| | | | - Carla de Agostino Biella
- Departamento de Gestão e Incorporação de Tecnologias em Saúde, Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde, Ministério da Saúde. Zona Cívico-Administrativa. 70058-900 Brasília DF Brasil.
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Abstract
BACKGROUND Health policy-makers must often make decisions in compressed time frames and with limited resources. Hence, rapid reviews have become a pragmatic alternative to comprehensive systematic reviews. However, it is important that rapid review methods remain rigorous to support good policy development and decisions. There is currently little evidence about which streamlined steps in a rapid review are less likely to introduce unacceptable levels of uncertainty while still producing a product that remains useful to policy-makers. METHODS This paper summarizes current research describing commonly used methods and practices that are used to conduct rapid reviews and presents key considerations and options to guide methodological choices for a rapid review. RESULTS The most important step for a rapid review is for an experienced research team to have early and ongoing engagement with the people who have requested the review. A clear research protocol, derived from a needs assessment conducted with the requester, serves to focus the review, defines the scope of the rapid review, and guides all subsequent steps. Common recommendations for rapid review methods include tailoring the literature search in terms of databases, dates, and languages. Researchers can consider using a staged search to locate high-quality systematic reviews and then subsequently published primary studies. The approaches used for study screening and selection, data extraction, and risk-of-bias assessment should be tailored to the topic, researcher experience, and available resources. Many rapid reviews use a single reviewer for study selection, risk-of-bias assessment, or data abstraction, sometimes with partial or full verification by a second reviewer. Rapid reviews usually use a descriptive synthesis method rather than quantitative meta-analysis. Use of brief report templates and standardized production methods helps to speed final report publication. CONCLUSIONS Researchers conducting rapid reviews need to make transparent methodological choices, informed by stakeholder input, to ensure that rapid reviews meet their intended purpose. Transparency is critical because it is unclear how or how much streamlined methods can bias the conclusions of reviews. There are not yet internationally accepted standards for conducting or reporting rapid reviews. Thus, this article proposes interim guidance for researchers who are increasingly employing these methods.
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Opportunities to improve reporting of rapid response in health technology assessment. Int J Technol Assess Health Care 2021; 38:e4. [DOI: 10.1017/s0266462321000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Introduction
Mini health technology assessment (HTA) reports have been used to support policy makers and health systems by providing a timely summary of scientific evidence. The objective of this meta-epidemiologic study was to evaluate the quality of reporting of mini-HTA reports published in Brazil.
Methods
An electronic search for all mini-HTA reports published between 2014 and March 2019 was conducted in the SISREBRATS and CONITEC databases. The study selection and data extraction were performed by two independent assessors. The following data were extracted: bibliographic data; research question; characteristics of the population, health technologies and outcomes assessed; eligibility criteria; information about searches and study selection; risk of bias assessment; quality of evidence assessment; synthesis of results; and recommendation about the technology evaluated. A descriptive analysis was used to summarize the information retrieved from all the included mini-HTA reports.
Results
We included 103 mini-HTA reports, the great majority of which (92.3 percent) focused on the coverage of the technologies in the healthcare system, with more than 60 percent being about drugs. Only five mini-HTA reports (4.8 percent) gave reasons for the choice of outcomes, and fifteen (14.5 percent) discriminated between primary and secondary outcomes. All mini-HTAs reported the databases searched and 99 percent of them reported using Medline. Sixty percent of the mini-HTA reported assessing the risk of bias, and 52 percent reported assessing the quality of evidence.
Conclusion
The quality of reporting of the mini-HTA reports performed in Brazil is insufficient and needs to be improved to guarantee transparency and replicability.
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Wilson MG, Oliver S, Melendez-Torres GJ, Lavis JN, Waddell K, Dickson K. Paper 3: Selecting rapid review methods for complex questions related to health policy and system issues. Syst Rev 2021; 10:286. [PMID: 34717777 PMCID: PMC8556903 DOI: 10.1186/s13643-021-01834-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/08/2021] [Indexed: 11/11/2022] Open
Abstract
Approaches for rapid reviews that focus on streamlining systematic review methods are not always suitable for exploring complex policy questions, as developing and testing theories to explain these complexities requires configuring diverse qualitative, quantitative, and mixed methods studies. Our objective was therefore to provide a guide to selecting approaches for rapidly (i.e., within days to months) addressing complex questions related to health policy and system issues.We provide a two-stage, transdisciplinary collaborative process to select a rapid review approach to address complex policy questions, which consists of scoping the breadth and depth of the literature and then selecting an optimal approach to synthesis. The first stage (scoping the literature) begins with a discussion with the stakeholders requesting evidence to identify and refine the question for the review, which is then used to conduct preliminary searches and conceptually map the documents identified. In the second stage (selection of an optimal approach), further stakeholder consultation is required to refine and tailor the question and approach to identifying relevant documents to include. The approach to synthesizing the included documents is then guided by the final question, the breadth and depth of the literature, and the time available and can include a static or evolving conceptual framework to code and analyze a range of evidence. For areas already covered extensively by existing systematic reviews, the focus can be on summarizing and integrating the review findings, resynthesizing the primary studies, or updating the search and reanalyzing one or more of the systematic reviews.The choice of approaches for conducting rapid reviews is intertwined with decisions about how to manage projects, the amount of work to be done, and the knowledge already available, and our guide offers support to help make these strategic decisions.
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Affiliation(s)
- Michael G. Wilson
- McMaster Health Forum, McMaster University, Hamilton, Canada
- Department of Health Evidence and Impact, McMaster University, Hamilton, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada
| | - Sandy Oliver
- EPPI-Centre, University College London, London, UK
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | | | - John N. Lavis
- McMaster Health Forum, McMaster University, Hamilton, Canada
- Department of Health Evidence and Impact, McMaster University, Hamilton, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
- Department of Political Science, McMaster University, Hamilton, Canada
| | - Kerry Waddell
- McMaster Health Forum, McMaster University, Hamilton, Canada
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Arevalo-Rodriguez I, Buitrago-Garcia D, Simancas-Racines D, Zambrano-Achig P, Del Campo R, Ciapponi A, Sued O, Martinez-García L, Rutjes AW, Low N, Bossuyt PM, Perez-Molina JA, Zamora J. False-negative results of initial RT-PCR assays for COVID-19: A systematic review. PLoS One 2020; 15:e0242958. [PMID: 33301459 PMCID: PMC7728293 DOI: 10.1371/journal.pone.0242958] [Citation(s) in RCA: 350] [Impact Index Per Article: 87.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A false-negative case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is defined as a person with suspected infection and an initial negative result by reverse transcription-polymerase chain reaction (RT-PCR) test, with a positive result on a subsequent test. False-negative cases have important implications for isolation and risk of transmission of infected people and for the management of coronavirus disease 2019 (COVID-19). We aimed to review and critically appraise evidence about the rate of RT-PCR false-negatives at initial testing for COVID-19. METHODS We searched MEDLINE, EMBASE, LILACS, as well as COVID-19 repositories, including the EPPI-Centre living systematic map of evidence about COVID-19 and the Coronavirus Open Access Project living evidence database. Two authors independently screened and selected studies according to the eligibility criteria and collected data from the included studies. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the proportion of false-negative test results using a multilevel mixed-effect logistic regression model. The certainty of the evidence about false-negative cases was rated using the GRADE approach for tests and strategies. All information in this article is current up to July 17, 2020. RESULTS We included 34 studies enrolling 12,057 COVID-19 confirmed cases. All studies were affected by several risks of bias and applicability concerns. The pooled estimate of false-negative proportion was highly affected by unexplained heterogeneity (tau-squared = 1.39; 90% prediction interval from 0.02 to 0.54). The certainty of the evidence was judged as very low due to the risk of bias, indirectness, and inconsistency issues. CONCLUSIONS There is substantial and largely unexplained heterogeneity in the proportion of false-negative RT-PCR results. The collected evidence has several limitations, including risk of bias issues, high heterogeneity, and concerns about its applicability. Nonetheless, our findings reinforce the need for repeated testing in patients with suspicion of SARS-Cov-2 infection given that up to 54% of COVID-19 patients may have an initial false-negative RT-PCR (very low certainty of evidence). SYSTEMATIC REVIEW REGISTRATION Protocol available on the OSF website: https://tinyurl.com/vvbgqya.
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Affiliation(s)
- Ingrid Arevalo-Rodriguez
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Diana Buitrago-Garcia
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud “Eugenio Espejo”, Universidad UTE, Quito, Ecuador
| | - Paula Zambrano-Achig
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Rosa Del Campo
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Omar Sued
- Fundación Huésped, Buenos Aires, Argentina
| | - Laura Martinez-García
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Anne W. Rutjes
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Patrick M. Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Jose A. Perez-Molina
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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Arevalo-Rodriguez I, Buitrago-Garcia D, Simancas-Racines D, Zambrano-Achig P, Del Campo R, Ciapponi A, Sued O, Martinez-García L, Rutjes AW, Low N, Bossuyt PM, Perez-Molina JA, Zamora J. False-negative results of initial RT-PCR assays for COVID-19: A systematic review. PLoS One 2020; 15:e0242958. [PMID: 33301459 DOI: 10.1101/2020.04.16.20066787] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/12/2020] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND A false-negative case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is defined as a person with suspected infection and an initial negative result by reverse transcription-polymerase chain reaction (RT-PCR) test, with a positive result on a subsequent test. False-negative cases have important implications for isolation and risk of transmission of infected people and for the management of coronavirus disease 2019 (COVID-19). We aimed to review and critically appraise evidence about the rate of RT-PCR false-negatives at initial testing for COVID-19. METHODS We searched MEDLINE, EMBASE, LILACS, as well as COVID-19 repositories, including the EPPI-Centre living systematic map of evidence about COVID-19 and the Coronavirus Open Access Project living evidence database. Two authors independently screened and selected studies according to the eligibility criteria and collected data from the included studies. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the proportion of false-negative test results using a multilevel mixed-effect logistic regression model. The certainty of the evidence about false-negative cases was rated using the GRADE approach for tests and strategies. All information in this article is current up to July 17, 2020. RESULTS We included 34 studies enrolling 12,057 COVID-19 confirmed cases. All studies were affected by several risks of bias and applicability concerns. The pooled estimate of false-negative proportion was highly affected by unexplained heterogeneity (tau-squared = 1.39; 90% prediction interval from 0.02 to 0.54). The certainty of the evidence was judged as very low due to the risk of bias, indirectness, and inconsistency issues. CONCLUSIONS There is substantial and largely unexplained heterogeneity in the proportion of false-negative RT-PCR results. The collected evidence has several limitations, including risk of bias issues, high heterogeneity, and concerns about its applicability. Nonetheless, our findings reinforce the need for repeated testing in patients with suspicion of SARS-Cov-2 infection given that up to 54% of COVID-19 patients may have an initial false-negative RT-PCR (very low certainty of evidence). SYSTEMATIC REVIEW REGISTRATION Protocol available on the OSF website: https://tinyurl.com/vvbgqya.
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Affiliation(s)
- Ingrid Arevalo-Rodriguez
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Diana Buitrago-Garcia
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador
| | - Paula Zambrano-Achig
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Rosa Del Campo
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Agustin Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Omar Sued
- Fundación Huésped, Buenos Aires, Argentina
| | - Laura Martinez-García
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Anne W Rutjes
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Jose A Perez-Molina
- Infectious Diseases Department, National Referral Centre for Tropical Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal- IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
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Arevalo-Rodriguez I, Steingart KR, Tricco AC, Nussbaumer-Streit B, Kaunelis D, Alonso-Coello P, Baxter S, Bossuyt PM, Emparanza JI, Zamora J. Current methods for development of rapid reviews about diagnostic tests: an international survey. BMC Med Res Methodol 2020; 20:115. [PMID: 32404051 PMCID: PMC7220561 DOI: 10.1186/s12874-020-01004-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Rapid reviews (RRs) have emerged as an efficient alternative to time-consuming systematic reviews-they can help meet the demand for accelerated evidence synthesis to inform decision-making in healthcare. The synthesis of diagnostic evidence has important methodological challenges. Here, we performed an international survey to identify the current practice of producing RRs for diagnostic tests. METHODS We developed and administered an online survey inviting institutions that perform RRs of diagnostic tests from all over the world. RESULTS All participants (N = 25) reported the implementation of one or more methods to define the scope of the RR; however, only one strategy (defining a structured question) was used by ≥90% of participants. All participants used at least one methodological shortcut including the use of a previous review as a starting point (92%) and the use of limits on the search (96%). Parallelization and automation of review tasks were not extensively used (48 and 20%, respectively). CONCLUSION Our survey indicates a greater use of shortcuts and limits for conducting diagnostic test RRs versus the results of a recent scoping review analyzing published RRs. Several shortcuts are used without knowing how their implementation affects the results of the evidence synthesis in the setting of diagnostic test reviews. Thus, a structured evaluation of the challenges and implications of the adoption of these RR methods is warranted.
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Affiliation(s)
- Ingrid Arevalo-Rodriguez
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, IRYCIS, CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Karen R. Steingart
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Andrea C. Tricco
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
- Epidemiology Division, Dalla Lana School of Public Health and Institute of Health Policy, Management and Evaluation at the University of Toronto, Toronto, Canada
- Queen’s Collaboration for Health Care Quality, Joanna Briggs Institute Centre of Excellence, Queen’s University, Kingston, Canada
| | | | - David Kaunelis
- Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center-Servicio de Epidemiología Clínica y Salud Pública, Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health, Barcelona, Spain
| | - Susan Baxter
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Patrick M. Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - José Ignacio Emparanza
- Clinical Epidemiology Unit, Hospital Universitario Donostia, BioDonostia, CIBER of Epidemiology and Public Health, San Sebastian, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, IRYCIS, CIBER of Epidemiology and Public Health, Madrid, Spain
- Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK
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10
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Camilleri M, Gogolishvili D, Giliauskas DL, Globerman J, Wilson M. Evaluation of an HIV-specific rapid response service for community-based organisations in Ontario, Canada. Health Res Policy Syst 2019; 17:80. [PMID: 31412942 PMCID: PMC6693275 DOI: 10.1186/s12961-019-0476-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 07/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background To support AIDS service organisations and other community-based organisations’ use of research evidence to inform HIV-related programmes, services and policies, the Ontario HIV Treatment Network (OHTN) developed a Rapid Response Service. The final product of the rapid response process at the OHTN, which is more streamlined than that of traditional systematic reviews, consists of a detailed report answering questions regarding an HIV-specific issue and how the findings apply within the local context. In 2016, the OHTN conducted an evaluation to assess the effectiveness of its Rapid Response Service. This article reports on the development of this service as well as the results of the evaluation. Methods All rapid responses published between January 1, 2009, and September 30, 2016, by the OHTN (n = 102) were analysed using univariate analyses. Frequency distributions were determined for the following variables for each rapid response: populations observed, topics covered, requestor affiliations and number of downloads from the OHTN’s website. Requestors of rapid responses were also interviewed regarding perceived helpfulness and utility of the service and final products, and suggestions for changes to the service. Six-month follow-up interviews were conducted to determine how affiliated organisations used the evidence from the rapid response they requested. Results The 102 rapid responses published covered 14 different populations of interest. Topics covered included the HIV prevention, engagement and care cascade, determinants of health, syndemics, and comorbidities. Requestor affiliations consisted of AIDS service organisations, government agencies and policy-makers, non-HIV-focused community-based organisations, and hospitals, universities or health centres. Requestors perceived most aspects of the Rapid Response Service as very helpful and most frequently suggested that the rapid responses should provide recommendations. Follow-up interviews regarding the impact of rapid responses show that rapid responses have been used to assist organisations in numerous activities. Conclusions Organisations that have used the OHTN’s Rapid Response Service describe it as a valuable service useful for the development of programmes and policies. Improvements in capacity-building efforts may increase its utility. Describing the findings of this evaluation may serve as a reference for similar programmes to increase the use of research evidence among public health decision-makers. Electronic supplementary material The online version of this article (10.1186/s12961-019-0476-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle Camilleri
- The Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, Ontario, M4T 1X3, Canada.
| | - David Gogolishvili
- The Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, Ontario, M4T 1X3, Canada
| | - Danielle L Giliauskas
- The Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, Ontario, M4T 1X3, Canada
| | - Jason Globerman
- The Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, Ontario, M4T 1X3, Canada
| | - Michael Wilson
- Department of Health Research Methods, Evidence and Impact, McMaster Health Forum, 1280 Main St West, MML-417, Hamilton, Ontario, L8S 4L6, Canada
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11
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Moore G, Redman S, Rudge S, Haynes A. Do policy-makers find commissioned rapid reviews useful? Health Res Policy Syst 2018; 16:17. [PMID: 29482643 PMCID: PMC5828139 DOI: 10.1186/s12961-018-0293-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 01/30/2018] [Indexed: 11/21/2022] Open
Abstract
Background Rapid reviews are increasingly used by policy agencies to access relevant research in short timeframes. Despite the growing number of programmes, little is known about how rapid reviews are used by health policy agencies. This study examined whether and how rapid reviews commissioned using a knowledge brokering programme were used by Australian policy-makers. Methods This study used interview data to examine the use of 139 rapid reviews by health policy agencies that were commissioned between 2006 and 2015. Transcripts were coded to identify how rapid reviews were used, the type of policy processes in which they were used, what evidence of use was provided and what reasons were given when rapid reviews were not used. Fisher’s exact test was used to assess variation between types of agencies. Results Overall, 89% of commissioned rapid reviews were used by the commissioning agencies and 338 separate instances of use were identified, namely, on average, three uses per review. Policy-makers used reviews primarily to determine the details of a policy or programme, identify priorities for future action or investment, negotiate interjurisdictional decisions, evaluate alternative solutions for a policy problem, and communicate information to stakeholders. Some variation in use was observed across agencies. Reasons for non-use were related to changes in organisational structures, resources or key personnel in the commissioning agencies, or changes in the broader political environment. Conclusions This study found that almost all rapid reviews had been used by the agencies who commissioned them, primarily in policy and programme development, agenda-setting, and to communicate information to stakeholders. Reviews were used mostly in instrumental and conceptual ways and there was little evidence of symbolic use. Variations in use were identified across agencies. The findings suggest that commissioned rapid reviews are an effective means of providing timely relevant research for use in policy processes and that review findings may be applied in a variety of ways. Electronic supplementary material The online version of this article (10.1186/s12961-018-0293-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gabriel Moore
- The Sax Institute, Level 13, Building 10, 235 Jones Street Ultimo NSW 2007, PO Box K617, Haymarket, NSW, 1240, Australia. .,School of Public Health, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia.
| | - Sally Redman
- The Sax Institute, Level 13, Building 10, 235 Jones Street Ultimo NSW 2007, PO Box K617, Haymarket, NSW, 1240, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - Sian Rudge
- The Sax Institute, Level 13, Building 10, 235 Jones Street Ultimo NSW 2007, PO Box K617, Haymarket, NSW, 1240, Australia
| | - Abby Haynes
- The Sax Institute, Level 13, Building 10, 235 Jones Street Ultimo NSW 2007, PO Box K617, Haymarket, NSW, 1240, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
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Acosta AM, Oelke ND, Lima MADDS. CONSIDERAÇÕES TEÓRICAS DO DIÁLOGO DELIBERATIVO: CONTRIBUIÇÕES PARA PRÁTICA, POLÍTICA E PESQUISA EM ENFERMAGEM. ACTA ACUST UNITED AC 2018. [DOI: 10.1590/0104-07072017000520017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo: este estudo visa discutir e refletir sobre concepções teóricas e metodológicas no uso do diálogo deliberativo e sua contribuição para prática, política e pesquisa em enfermagem. Método: foi realizado estudo teórico e reflexivo sobre a abordagem metodológica do processo de deliberação e suas concepções teóricas. O artigo também fornece uma descrição geral das principais características e passos fundamentais que podem ser utilizados para guiar o desenvolvimento uma sessão de deliberação. Resultados: diálogo deliberativo envolve conversações propositadas e facilitadas entre pessoas interessadas para alcançar consenso sobre prioridades em serviços de saúde e decidir coletivamente sobre estratégias para ação utilizando síntese de evidências de pesquisas e experiência contextual. É uma estratégia de translação de conhecimento que envolve indivíduos, comunidades e instituições no uso de conhecimento científico para realizar mudanças fundamentadas. As principais características desse método são seleção cuidadosa dos participantes, elaboração de documento de leitura com síntese de evidências, facilitação neutra e habilidosa, uso de abordagens inovadoras para atividades grupais e análise de dados com métodos integrados. Conclusão: princípios de diálogo deliberativo têm sido utilizados para a tomada de decisão política, com pouco uso nos cuidados de enfermagem. Seu uso pode ser uma experiência única para o campo de enfermagem, contribuindo para mudanças nas práticas e políticas. Também pode ser utilizado como estratégia para coleta dados em pesquisa qualitativa, como uma nova forma de construir conhecimento científico. Diálogo deliberativo é uma abordagem inovadora que pode proporcionar enfermeiros mais críticos-reflexivos, mais práticas baseadas em evidências e melhores resultados de saúde.
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Bornstein S, Baker R, Navarro P, Mackey S, Speed D, Sullivan M. Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers. Syst Rev 2017; 6:218. [PMID: 29096710 PMCID: PMC5667442 DOI: 10.1186/s13643-017-0606-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. METHODS As an integrated knowledge translation (KT) method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies. Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations. RESULTS CHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including: Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing; Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth; Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; and Health promotion: diabetes prevention, promoting healthy dietary habits. These studies have been used by decision makers to inform local policy and practice decisions. CONCLUSIONS By asking the health system to identify its own priorities and to participate directly in the research process, CHRSP fully integrates KT among researchers and knowledge users in healthcare in Newfoundland and Labrador. This high level of decision-maker buy-in has resulted in a corresponding level of uptake. CHRSP studies have directly informed a number of policy and practice directions, including the design of youth residential treatment centers, a provincial policy on single-use medical devices, and most recently, the opening of the province's first Acute Care for the Elderly hospital unit.
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Affiliation(s)
- Stephen Bornstein
- Newfoundland and Labrador Centre for Applied Health Research, 95 Bonaventure Avenue, Suite 300, St. John's, NL, A1B 2X5, Canada.
| | - Rochelle Baker
- Newfoundland and Labrador Centre for Applied Health Research, 95 Bonaventure Avenue, Suite 300, St. John's, NL, A1B 2X5, Canada
| | - Pablo Navarro
- Newfoundland and Labrador Centre for Applied Health Research, 95 Bonaventure Avenue, Suite 300, St. John's, NL, A1B 2X5, Canada
| | - Sarah Mackey
- Newfoundland and Labrador Centre for Applied Health Research, 95 Bonaventure Avenue, Suite 300, St. John's, NL, A1B 2X5, Canada
| | - David Speed
- Newfoundland and Labrador Centre for Applied Health Research, 95 Bonaventure Avenue, Suite 300, St. John's, NL, A1B 2X5, Canada
| | - Melissa Sullivan
- Newfoundland and Labrador Centre for Applied Health Research, 95 Bonaventure Avenue, Suite 300, St. John's, NL, A1B 2X5, Canada
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14
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Quasi-experimental study designs series—paper 11: supporting the production and use of health systems research syntheses that draw on quasi-experimental study designs. J Clin Epidemiol 2017; 89:92-97. [DOI: 10.1016/j.jclinepi.2017.03.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 03/19/2017] [Accepted: 03/21/2017] [Indexed: 12/17/2022]
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15
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Moore G, Redman S, D'Este C, Makkar S, Turner T. Does knowledge brokering improve the quality of rapid review proposals? A before and after study. Syst Rev 2017; 6:23. [PMID: 28129795 PMCID: PMC5273818 DOI: 10.1186/s13643-017-0411-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid reviews are increasingly being used to help policy makers access research in short time frames. A clear articulation of the review's purpose, questions, scope, methods and reporting format is thought to improve the quality and generalisability of review findings. The aim of the study is to explore the effectiveness of knowledge brokering in improving the perceived clarity of rapid review proposals from the perspective of potential reviewers. To conduct the study, we drew on the Evidence Check program, where policy makers draft a review proposal (a pre knowledge brokering proposal) and have a 1-hour session with a knowledge broker, who re-drafts the proposal based on the discussion (a post knowledge brokering proposal). METHODS We asked 30 reviewers who had previously undertaken Evidence Check reviews to examine the quality of 60 pre and 60 post knowledge brokering proposals. Reviewers were blind to whether the review proposals they received were pre or post knowledge brokering. Using a six-point Likert scale, reviewers scored six questions examining clarity of information about the review's purpose, questions, scope, method and format and reviewers' confidence that they could meet policy makers' needs. Each reviewer was allocated two pre and two post knowledge brokering proposals, randomly ordered, from the 60 reviews, ensuring no reviewer received a pre and post knowledge brokering proposal from the same review. RESULTS The results showed that knowledge brokering significantly improved the scores for all six questions addressing the perceived clarity of the review proposal and confidence in meeting policy makers' needs; with average changes of 0.68 to 1.23 from pre to post across the six domains. CONCLUSIONS This study found that knowledge brokering increased the perceived clarity of information provided in Evidence Check rapid review proposals and the confidence of reviewers that they could meet policy makers' needs. Further research is needed to identify how the knowledge brokering process achieves these improvements and to test the applicability of the findings in other rapid review programs.
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Affiliation(s)
- Gabriel Moore
- School of Public Health, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia. .,The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia.
| | - Sally Redman
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Population Health (NCEPH), Research School of Population Health, The Australian National University, 62 Mills Road, Acton, ACT, 0200, Australia
| | - Steve Makkar
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Tari Turner
- School of Public Health and Preventive Medicine, Monash University, Level 1, 549 St Kilda Road, Melbourne, VIC, 3004, Australia
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Abou-Setta AM, Jeyaraman M, Attia A, Al-Inany HG, Ferri M, Ansari MT, Garritty CM, Bond K, Norris SL. Methods for Developing Evidence Reviews in Short Periods of Time: A Scoping Review. PLoS One 2016; 11:e0165903. [PMID: 27930662 PMCID: PMC5145149 DOI: 10.1371/journal.pone.0165903] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 10/19/2016] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Rapid reviews (RR), using abbreviated systematic review (SR) methods, are becoming more popular among decision-makers. This World Health Organization commissioned study sought to summarize RR methods, identify differences, and highlight potential biases between RR and SR. METHODS Review of RR methods (Key Question 1 [KQ1]), meta-epidemiologic studies comparing reliability/ validity of RR and SR methods (KQ2), and their potential associated biases (KQ3). We searched Medline, EMBASE, Cochrane Library, grey literature, and checked reference lists, used personal contacts, and crowdsourcing (e.g. email listservs). Selection and data extraction was conducted by one reviewer (KQ1) or two reviewers independently (KQ2-3). RESULTS Across all KQs, we identified 42,743 citations through the literature searches. KQ1: RR methods from 29 organizations were reviewed. There was no consensus on which aspects of the SR process to abbreviate. KQ2: Studies comparing the conclusions of RR and SR (n = 9) found them to be generally similar. Where major differences were identified, it was attributed to the inclusion of evidence from different sources (e.g. searching different databases or including different study designs). KQ3: Potential biases introduced into the review process were well-identified although not necessarily supported by empirical evidence, and focused mainly on selective outcome reporting and publication biases. CONCLUSION RR approaches are context and organization specific. Existing comparative evidence has found similar conclusions derived from RR and SR, but there is a lack of evidence comparing the potential of bias in both evidence synthesis approaches. Further research and decision aids are needed to help decision makers and reviewers balance the benefits of providing timely evidence with the potential for biased findings.
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Affiliation(s)
- Ahmed M. Abou-Setta
- Knowledge Synthesis Platform, George & Fay Yee Center for Healthcare Innovation, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Maya Jeyaraman
- Knowledge Synthesis Platform, George & Fay Yee Center for Healthcare Innovation, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Abdelhamid Attia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, El-Manial, Cairo, Egypt
| | - Hesham G. Al-Inany
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, El-Manial, Cairo, Egypt
| | - Mauricio Ferri
- World Health Organization, Geneva, Republic and Canton of Geneva, Switzerland
| | - Mohammed T. Ansari
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Chantelle M. Garritty
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kenneth Bond
- Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada
| | - Susan L. Norris
- World Health Organization, Geneva, Republic and Canton of Geneva, Switzerland
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Haby MM, Chapman E, Clark R, Barreto J, Reveiz L, Lavis JN. What are the best methodologies for rapid reviews of the research evidence for evidence-informed decision making in health policy and practice: a rapid review. Health Res Policy Syst 2016; 14:83. [PMID: 27884208 PMCID: PMC5123411 DOI: 10.1186/s12961-016-0155-7] [Citation(s) in RCA: 189] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/02/2016] [Indexed: 12/11/2022] Open
Abstract
Background Rapid reviews have the potential to overcome a key barrier to the use of research evidence in decision making, namely that of the lack of timely and relevant research. This rapid review of systematic reviews and primary studies sought to answer the question: What are the best methodologies to enable a rapid review of research evidence for evidence-informed decision making in health policy and practice? Methods This rapid review utilised systematic review methods and was conducted according to a pre-defined protocol including clear inclusion criteria (PROSPERO registration: CRD42015015998). A comprehensive search strategy was used, including published and grey literature, written in English, French, Portuguese or Spanish, from 2004 onwards. Eleven databases and two websites were searched. Two review authors independently applied the eligibility criteria. Data extraction was done by one reviewer and checked by a second. The methodological quality of included studies was assessed independently by two reviewers. A narrative summary of the results is presented. Results Five systematic reviews and one randomised controlled trial (RCT) that investigated methodologies for rapid reviews met the inclusion criteria. None of the systematic reviews were of sufficient quality to allow firm conclusions to be made. Thus, the findings need to be treated with caution. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting rapid reviews. While a wide range of ‘shortcuts’ are used to make rapid reviews faster than a full systematic review, the included studies found little empirical evidence of their impact on the conclusions of either rapid or systematic reviews. There is some evidence from the included RCT (that had a low risk of bias) that rapid reviews may improve clarity and accessibility of research evidence for decision makers. Conclusions Greater care needs to be taken in improving the transparency of the methods used in rapid review products. There is no evidence available to suggest that rapid reviews should not be done or that they are misleading in any way. We offer an improved definition of rapid reviews to guide future research as well as clearer guidance for policy and practice. Electronic supplementary material The online version of this article (doi:10.1186/s12961-016-0155-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle M Haby
- Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora, Mexico. .,Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
| | | | - Rachel Clark
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jorge Barreto
- Fundação Oswaldo Cruz, Diretoria de Brasília, Brasilia, Brazil
| | - Ludovic Reveiz
- Knowledge Management, Bioethics and Research, Pan American Health Organization, Washington, DC, United States of America
| | - John N Lavis
- McMaster Health Forum, Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, and Department of Political Science, McMaster University, Hamilton, Canada.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Garritty C, Stevens A, Gartlehner G, King V, Kamel C. Cochrane Rapid Reviews Methods Group to play a leading role in guiding the production of informed high-quality, timely research evidence syntheses. Syst Rev 2016; 5:184. [PMID: 27793186 PMCID: PMC5084365 DOI: 10.1186/s13643-016-0360-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/18/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Policymakers and healthcare stakeholders are increasingly seeking evidence to inform the policymaking process, and often use existing or commissioned systematic reviews to inform decisions. However, the methodologies that make systematic reviews authoritative take time, typically 1 to 2 years to complete. Outside the traditional SR timeline, "rapid reviews" have emerged as an efficient tool to get evidence to decision-makers more quickly. However, the use of rapid reviews does present challenges. To date, there has been limited published empirical information about this approach to compiling evidence. Thus, it remains a poorly understood and ill-defined set of diverse methodologies with various labels. In recent years, the need to further explore rapid review methods, characteristics, and their use has been recognized by a growing network of healthcare researchers, policymakers, and organizations, several with ties to Cochrane, which is recognized as representing an international gold standard for high-quality, systematic reviews. PURPOSE In this commentary, we introduce the newly established Cochrane Rapid Reviews Methods Group developed to play a leading role in guiding the production of rapid reviews given they are increasingly employed as a research synthesis tool to support timely evidence-informed decision-making. We discuss how the group was formed and outline the group's structure and remit. We also discuss the need to establish a more robust evidence base for rapid reviews in the published literature, and the importance of promoting registration of rapid review protocols in an effort to promote efficiency and transparency in research. CONCLUSION As with standard systematic reviews, the core principles of evidence-based synthesis should apply to rapid reviews in order to minimize bias to the extent possible. The Cochrane Rapid Reviews Methods Group will serve to establish a network of rapid review stakeholders and provide a forum for discussion and training. By facilitating exchange, the group will strive to conduct research to advance the methods of rapid reviews.
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Affiliation(s)
- Chantelle Garritty
- Ottawa Methods Centre, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada. .,Translational Research in Biomedicine (TRIBE) Graduate Program, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia.
| | - Adrienne Stevens
- Ottawa Methods Centre, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.,Translational Research in Biomedicine (TRIBE) Graduate Program, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia
| | - Gerald Gartlehner
- Cochrane Austria, Danube University, Krems, Dr. Karl Dorrek Strasse 30, 3500, Krems, Austria.,RTI International, 3040 East Cornwallis Rd, Research Triangle Park, NC, 27709, USA
| | - Valerie King
- The Center for Evidence-based Policy, Oregon Health & Science University, 3030 SW Moody Avenue, Portland, OR, 97201, USA
| | - Chris Kamel
- Canadian Agency for Drugs and Technologies in Health (CADTH), 600-865 Carling Ave., Ottawa, Ontario, K1S 5S8, Canada
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Haby MM, Chapman E, Clark R, Barreto J, Reveiz L, Lavis JN. Designing a rapid response program to support evidence-informed decision-making in the Americas region: using the best available evidence and case studies. Implement Sci 2016; 11:117. [PMID: 27538384 PMCID: PMC4990866 DOI: 10.1186/s13012-016-0472-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 07/15/2016] [Indexed: 01/08/2023] Open
Abstract
Background The objective of this work was to inform the design of a rapid response program to support evidence-informed decision-making in health policy and practice for the Americas region. Specifically, we focus on the following: (1) What are the best methodological approaches for rapid reviews of the research evidence? (2) What other strategies are needed to facilitate evidence-informed decision-making in health policy and practice? and (3) How best to operationalize a rapid response program? Methods The evidence used to inform the design of a rapid response program included (i) two rapid reviews of methodological approaches for rapid reviews of the research evidence and strategies to facilitate evidence-informed decision-making, (ii) supplementary literature in relation to the “shortcuts” that could be considered to reduce the time needed to complete rapid reviews, (iii) four case studies, and (iv) supplementary literature to identify additional operational issues for the design of the program. Results There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting them. Better reporting of rapid review methods is needed. The literature found in relation to shortcuts will be helpful in choosing shortcuts that maximize timeliness while minimizing the impact on quality. Evidence for other strategies that can be used concurrently to facilitate the uptake of research evidence, including evidence drawn from rapid reviews, is presented. Operational issues that need to be considered in designing a rapid response program include the implications of a “user-pays” model, the importance of recruiting staff with the right mix of skills and qualifications, and ensuring that the impact of the model on research use in decision-making is formally evaluated. Conclusions When designing a new rapid response program, greater attention needs to be given to specifying the rapid review methods and reporting these in sufficient detail to allow a quality assessment. It will also be important to engage in other strategies to facilitate the uptake of the rapid reviews and to evaluate the chosen model in order to make refinements and add to the evidence base for evidence-informed decision-making. Electronic supplementary material The online version of this article (doi:10.1186/s13012-016-0472-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle M Haby
- Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora, México. .,Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | | | - Rachel Clark
- Centre of Excellence in Intervention and Prevention Science, Melbourne, Australia
| | - Jorge Barreto
- Fundação Oswaldo Cruz, Diretoria de Brasília, Brazil
| | - Ludovic Reveiz
- Knowledge Management, Bioethics and Research, Pan American Health Organization, Washington, DC, USA
| | - John N Lavis
- McMaster Health Forum, Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, and Department of Political Science, McMaster University, Hamilton, Canada.,Department of Global Health and Population Boston, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Manson H. Systematic reviews are not enough: policymakers need a greater variety of synthesized evidence. J Clin Epidemiol 2016; 73:11-4. [DOI: 10.1016/j.jclinepi.2015.08.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/13/2015] [Indexed: 02/06/2023]
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Yusuf A, Elsabbagh M. At the cross-roads of participatory research and biomarker discovery in autism: the need for empirical data. BMC Med Ethics 2015; 16:88. [PMID: 26669759 PMCID: PMC4681135 DOI: 10.1186/s12910-015-0082-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 12/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying biomarkers for autism can improve outcomes for those affected by autism. Engaging the diverse stakeholders in the research process using community-based participatory research (CBPR) can accelerate biomarker discovery into clinical applications. However, there are limited examples of stakeholder involvement in autism research, possibly due to conceptual and practical concerns. We evaluate the applicability of CBPR principles to biomarker discovery in autism and critically review empirical studies adopting these principles. METHODS Using a scoping review methodology, we identified and evaluated seven studies using CBPR principles in biomarker discovery. RESULTS AND CONCLUSIONS The limited number of studies in biomarker discovery adopting CBPR principles coupled with their methodological limitations suggests that such applications are feasible but challenging. These studies illustrate three CBPR themes: community assessment, setting global priorities, and collaboration in research design. We propose that further research using participatory principles would be useful in accelerating the pace of discovery and the development of clinically meaningful biomarkers. For this goal to be successful we advocate for increased attention to previously identified conceptual and methodological challenges to participatory approaches in health research, including improving scientific rigor and developing long-term partnerships among stakeholders.
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Affiliation(s)
- Afiqah Yusuf
- Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
| | - Mayada Elsabbagh
- Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
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Tsertsvadze A, Chen YF, Moher D, Sutcliffe P, McCarthy N. How to conduct systematic reviews more expeditiously? Syst Rev 2015; 4:160. [PMID: 26563648 PMCID: PMC4643500 DOI: 10.1186/s13643-015-0147-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 10/28/2015] [Indexed: 01/19/2023] Open
Abstract
Healthcare consumers, researchers, patients and policy makers increasingly use systematic reviews (SRs) to aid their decision-making process. However, the conduct of SRs can be a time-consuming and resource-intensive task. Often, clinical practice guideline developers or other decision-makers need to make informed decisions in a timely fashion (e.g. outbreaks of infection, hospital-based health technology assessments). Possible approaches to address the issue of timeliness in the production of SRs are to (a) implement process parallelisation, (b) adapt and apply innovative technologies, and/or (c) modify SR processes (e.g. study eligibility criteria, search sources, data extraction or quality assessment). Highly parallelised systematic reviewing requires substantial resources to support a team of experienced information specialists, reviewers and methodologists working alongside with clinical content experts to minimise the time for completing individual review steps while maximising the parallel progression of multiple steps. Effective coordination and management within the team and across external stakeholders are essential elements of this process. Emerging innovative technologies have a great potential for reducing workload and improving efficiency of SR production. The most promising areas of application would be to allow automation of specific SR tasks, in particular if these tasks are time consuming and resource intensive (e.g. language translation, study selection, data extraction). Modification of SR processes involves restricting, truncating and/or bypassing one or more SR steps, which may risk introducing bias to the review findings. Although the growing experiences in producing various types of rapid reviews (RR) and the accumulation of empirical studies exploring potential bias associated with specific SR tasks have contributed to the methodological development for expediting SR production, there is still a dearth of research examining the actual impact of methodological modifications and comparing the findings between RRs and SRs. This evidence would help to inform as to which SR tasks can be accelerated or truncated and to what degree, while maintaining the validity of review findings. Timely delivered SRs can be of value in informing healthcare decisions and recommendations, especially when there is practical urgency and there is no other relevant synthesised evidence.
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Affiliation(s)
- Alexander Tsertsvadze
- Communicable Disease Control Epidemiology and Evidence, Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Yen-Fu Chen
- Warwick Centre for Applied Health Research & Delivery (W-CAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - David Moher
- Ottawa Methods Centre, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, Centre for Practice Changing Research Building, 501 Smyth Road, PO BOX 201B, Ottawa, Ontario, K1H 8L6, Canada.
| | - Paul Sutcliffe
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Noel McCarthy
- Communicable Disease Control Epidemiology and Evidence, Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
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Polisena J, Garritty C, Umscheid CA, Kamel C, Samra K, Smith J, Vosilla A. Rapid Review Summit: an overview and initiation of a research agenda. Syst Rev 2015; 4:111. [PMID: 26407674 PMCID: PMC4583747 DOI: 10.1186/s13643-015-0111-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 09/07/2015] [Indexed: 11/10/2022] Open
Abstract
The demand for accelerated forms of evidence synthesis is on the rise, largely in response to requests by health care decision makers for expeditious assessment and up-to-date information about health care technologies and health services and programs. As a field, rapid review evidence synthesis is marked by a tension between the strategic priority to inform health care decision-making and the scientific imperative to produce robust, high-quality research that soundly supports health policy and practice. In early 2015, the Canadian Agency for Drugs and Technologies in Health convened a forum in partnership with the British Columbia Ministry of Health, the British Columbia Centre for Clinical Epidemiology and Evaluation, the Ottawa Hospital Research Institute, and the University of Pennsylvania. More than 150 evidence synthesis producers and end users attended the Rapid Review Summit: Then, Now and in the Future. The Summit program focused on the evolving role and practices of rapid reviews to support informed health care policy and clinical decision-making, including the uptake and use of health technology assessment. Our discussion paper highlights the important discussions that occurred during the Rapid Review Summit. It focuses on the initial development of a research agenda that resulted from the Summit presentations and discussions. The research topics centered on three key areas of interest: (1) how to conduct a rapid review; (2) investigating the validity and utility of rapid reviews; and (3) how to improve access to rapid reviews.
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Affiliation(s)
- Julie Polisena
- Canadian Agency for Drugs and Technologies in Health (CADTH), 600-865 Carling Ave., Ottawa, ON, K1S 5S8, Canada. .,School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada.
| | - Chantelle Garritty
- Knowledge Synthesis Group, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada. .,Translational Research in Biomedicine (TRIBE) Graduate Program, University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia.
| | - Craig A Umscheid
- ECRI Institute - Penn Medicine AHRQ EPC and the Center for Evidence-Based Practice and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Chris Kamel
- Canadian Agency for Drugs and Technologies in Health (CADTH), 600-865 Carling Ave., Ottawa, ON, K1S 5S8, Canada.
| | - Kevin Samra
- Strategic Projects Branch, BC Ministry of Health, 5th floor, 1483 Douglas Street, PO BOX 9634 STN PROV GOVT, Victoria, British Columbia, Canada.
| | - Jeannette Smith
- Canadian Agency for Drugs and Technologies in Health (CADTH), 600-865 Carling Ave., Ottawa, ON, K1S 5S8, Canada.
| | - Ann Vosilla
- Canadian Agency for Drugs and Technologies in Health (CADTH), 600-865 Carling Ave., Ottawa, ON, K1S 5S8, Canada.
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Patient-centered rapid reviews will drive local decision making: commentary on Hartling et al. J Clin Epidemiol 2015; 68:1526-8. [PMID: 26277209 DOI: 10.1016/j.jclinepi.2015.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 06/23/2015] [Accepted: 07/09/2015] [Indexed: 11/24/2022]
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Wilson MG, Lavis JN, Gauvin FP. Developing a rapid-response program for health system decision-makers in Canada: findings from an issue brief and stakeholder dialogue. Syst Rev 2015; 4:25. [PMID: 25875495 PMCID: PMC4373100 DOI: 10.1186/s13643-015-0009-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/28/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There is currently no mechanism in place outside of government to provide rapid syntheses of the best available research evidence about problems, options and/or implementation considerations related to a specific health system challenge that Canadian health system decision-makers need to address in a timely manner. A 'rapid-response' program could address this gap by providing access to optimally packaged, relevant and high-quality research evidence over short periods of time (i.e. days or weeks). METHODS We prepared an issue brief that describes the best available research evidence related to the problem, three broad features of a program that addresses the problem and implementation considerations. We identified systematic reviews by searching for organization-targeted implementation strategies in Health Systems Evidence ( www.healthsystemsevidence.org ) and drew on an existing analytical framework for how knowledge-brokering organizations can organize themselves to operationalize the program features. The issue brief was then used to inform a half-day stakeholder dialogue about whether and how to develop a rapid-response program for health system decision-makers in Canada. We thematically synthesized the deliberations. RESULTS We found very few relevant systematic reviews but used frameworks and examples from existing programs to 1) outline key considerations for organizing a rapid-response program,, 2) determine what can be done in timelines ranging from 3 to 10 and 30 business days, and 3) define success and measure it. The 11 dialogue participants from across Canada largely agreed with the content presented in the brief, but noted two key challenges to consider: securing stable, long-term funding and finding a way to effectively and equitably manage the expected demand. Recommendations and suggestions for next steps from dialogue participants included taking an 'organic' approach to developing a pan-Canadian network and including jurisdictional scans as a type of product to deliver through the program (rather than only syntheses of research evidence). CONCLUSIONS Dialogue participants clearly signalled that there is an appetite for a rapid-response program for health system decision-makers in Canada. To 'organically' build such a program, we are currently engaging in efforts to build partnerships and secure funding to support the creation of a pan-Canadian network for conducting rapid syntheses for health system decision-makers in Canada.
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Affiliation(s)
- Michael G Wilson
- McMaster Health Forum, McMaster University, Hamilton, Canada. .,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada. .,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
| | - John N Lavis
- McMaster Health Forum, McMaster University, Hamilton, Canada. .,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada. .,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. .,Department of Political Science, McMaster University, Hamilton, Canada. .,Department of Global Health and Population, Harvard School of Public Health, Cambridge, USA.
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