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      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

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          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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          Most cited references21

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          SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking

          This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policy briefs are a relatively new approach to packaging research evidence for policymakers. The first step in a policy brief is to prioritise a policy issue. Once an issue is prioritised, the focus then turns to mobilising the full range of research evidence relevant to the various features of the issue. Drawing on available systematic reviews makes the process of mobilising evidence feasible in a way that would not otherwise be possible if individual relevant studies had to be identified and synthesised for every feature of the issue under consideration. In this article, we suggest questions that can be used to guide those preparing and using policy briefs to support evidence-informed policymaking. These are: 1. Does the policy brief address a high-priority issue and describe the relevant context of the issue being addressed? 2. Does the policy brief describe the problem, costs and consequences of options to address the problem, and the key implementation considerations? 3. Does the policy brief employ systematic and transparent methods to identify, select, and assess synthesised research evidence? 4. Does the policy brief take quality, local applicability, and equity considerations into account when discussing the synthesised research evidence? 5. Does the policy brief employ a graded-entry format? 6. Was the policy brief reviewed for both scientific quality and system relevance?
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            Rapid versus full systematic reviews: validity in clinical practice?

            Rapid reviews are being produced with greater frequency by health technology assessment (HTA) agencies in response to increased pressure from end-user clinicians and policy-makers for rapid, evidence-based advice on health-care technologies. This comparative study examines the differences in methodologies and essential conclusions between rapid and full reviews on the same topic, with the aim of determining the validity of rapid reviews in the clinical context and making recommendations for their future application. Rapid reviews were located by Internet searching of international HTA agency websites, with any ambiguities resolved by further communication with the agencies. Comparator full systematic reviews were identified using the University of York Centre for Reviews and Dissemination HTA database. Data on a number of review components were extracted using standardized data extraction tables, then analysed and reported narratively. Axiomatic differences between all the rapid and full reviews were identified; however, the essential conclusions of the rapid and full reviews did not differ extensively across the topics. For each of the four topics examined, it was clear that the scope of the rapid reviews was substantially narrower than that of full reviews. The methodology underpinning the rapid reviews was often inadequately described. Rapid reviews do not adhere to any single validated methodology. They frequently provide adequate advice on which to base clinical and policy decisions; however, their scope is limited, which may compromise their appropriateness for evaluating technologies in certain circumstances.
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              What is a rapid review? A methodological exploration of rapid reviews in Health Technology Assessments.

              Commissioners of Health Technology Assessments require timely reviews to attain efficacious decisions on healthcare and treatments. In recent years, there has been an emergence of 'rapid reviews' within Health Technology Assessments; however, there is no known published guidance or agreed methodology within recognised systematic review or Health Technology Assessment guidelines. In order to answer the research question 'What is a rapid review and is methodology consistent in rapid reviews of Health Technology Assessments?', a study was undertaken in a sample of rapid review Health Technology Assessments from the Health Technology Assessment database within the Cochrane Library and other specialised Health Technology Assessment databases to investigate similarities and/or differences in rapid review methodology utilised. In a targeted search to obtain a manageable sample of rapid reviews, the Health Technology Assessment database of The Cochrane Library and six international Health Technology Assessment databases were searched to locate rapid review Health Technology Assessments from 2000 onwards. Each rapid review was examined to investigate the individual methodology used for searching, inclusion screening, quality assessment, data extraction and synthesis. Methods of each rapid review were compared to investigate differences and/or similarities in methodologies used, in comparison with recognised methods for systematic reviews. Forty-six full rapid reviews and three extractable summaries of rapid reviews were included. There was a wide diversity of methodology, with some reviews utilising well-established systematic review methods, but many others diversifying in one or more areas, that is searching, inclusion screening, quality assessment, data extraction, synthesis methods, report structure and number of reviewers. There was a significant positive correlation between the number of recommended review methodologies utilised and length of time taken in months. Despite the number of rapid reviews published within Health Technology Assessments over recent years, there is no agreed and tested methodology and it is unclear how rapid reviews differ from systematic reviews. In a sample of Health Technology Assessment rapid reviews from 2000 to 2011, there was a wide diversity of methodology utilised in all aspects of rapid reviews. There is scope for wider research in this area to investigate the diversity of methods in more depth during each stage of the rapid review process, so that eventually recommendations could be made for clear and systematic methods for rapid reviews, thus facilitating equity and credibility of this type of important review methodology. © 2012 The Authors. International Journal of Evidence-Based Healthcare © 2012 The Joanna Briggs Institute.
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                Author and article information

                Contributors
                haby@unimelb.edu.au
                evelinachap@gmail.com
                rachel.x.clark@phe.gov.uk
                jorgebarreto@fiocruz.br
                reveizl@paho.org
                lavisj@mcmaster.ca
                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central (London )
                1478-4505
                25 November 2016
                25 November 2016
                2016
                : 14
                Affiliations
                [1 ]Department of Chemical and Biological Sciences, Universidad de Sonora, Hermosillo, Sonora Mexico
                [2 ]Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
                [3 ]Pan American Health Organization, Brasilia, DF Brazil
                [4 ]London School of Hygiene and Tropical Medicine, London, United Kingdom
                [5 ]Fundação Oswaldo Cruz, Diretoria de Brasília, Brasilia, Brazil
                [6 ]Knowledge Management, Bioethics and Research, Pan American Health Organization, Washington, DC, United States of America
                [7 ]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
                [8 ]Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA United States of America
                Article
                155
                10.1186/s12961-016-0155-7
                5123411
                27884208
                df4b034f-8466-499c-afbb-b3c3e55612e1
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100006506, Ministério da Saúde;
                Award ID: Cooperation agreement #47
                Award Recipient :
                Funded by: Pan American Health Organization
                Award ID: Cooperation agreement #47
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                rapid reviews,knowledge translation,evidence-informed decision-making,research uptake,health policy

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