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The Article Alert for the week of March 3, 2014 (sample articles)
Khangura S, Polisena J, Clifford TJ, Farrah K, Kamel C. Rapid Review: an Emerging Approach to Evidence Synthesis in Health Technology Assessment. Int.J.Technol.Assess.Health Care. Epub 2014 Jan 22. PMID: 24451157.
Background: Increasingly, healthcare decision makers demand quality evidence in a short timeframe to support urgent and emergent decisions related to procurement, clinical practice, and policy. Health technology assessment (HTA) producers are responding by developing innovative approaches to evidence synthesis that can be executed more quickly than traditional systematic review. These approaches, and the broader implications they bring to bear on health decision making and policy development, however, are generally neither well-understood nor well-described. This study intends to contribute to an emerging literature around methodological approaches to rapid review in HTA by outlining those developed and implemented by the Canadian Agency for Drugs and Technologies in Health (CADTH).
Methods: Since 2005, CADTH has developed and implemented a rapid review approach that synthesizes evidence to support informed healthcare decisions and policy. Rapid Response reports are tailored to the identified needs of Canadian health decision makers, representing a range of options with regard to depth, breadth, and time-to-delivery.
Results: Preliminary observations indicate that CADTH's approach to rapid evidence review is generally well-received by Canadian health decision makers; real-world case studies provide pragmatic examples of how health decision makers have used Rapid Response reports to support evidence-informed health decisions across Canada.
Conclusions: Rapid review is becoming an increasingly important approach to evidence synthesis, both within and external to the field of HTA. Transparent reporting of the methods used to develop rapid review products will be critical to the assessment of their relevance, utility and effects in a range of contexts.
- DOI: http://dx.doi.org/10.1017/S0266462313000664
- PubMed: http://www.ncbi.nlm.nih.gov/pubmed/24451157
Trikalinos TA, Segal JB, Boyd CM. Addressing Multimorbidity in Evidence Integration and Synthesis. J.Gen.Intern.Med. Epub 2014 Jan 18. PMID: 24442334.
To minimize bias, clinical practice guidelines (CPG) for managing patients with multiple conditions should be informed by well-planned syntheses of the totality of the relevant evidence by means of systematic reviews and meta-analyses. However, deficiencies along the entire evidentiary pathway hinder the development of evidence-based CPGs. Published reports of trials and observational studies often do not provide usable data on treatment effect heterogeneity, perhaps because their design, analysis and presentation is seldom geared towards informing on how multimorbidity modifies the effect of treatments. Systematic reviews and meta-analyses inherit all the limitations of their building blocks and introduce additional of their own, including selection biases at the level of the included studies, ecological biases, and analytical challenges. To generate recommendations to help negotiate some of the challenges in synthesizing the primary literature, so that the results of the evidence synthesis is applicable to the care of those with multiple conditions. Informal group process. We have built upon established general guidance, and provide additional recommendations specific to systematic reviews that could improve the CPGs for multimorbid patients. We suggest that following the additional recommendations is good practice, but acknowledge that not all proposed recommendations are of equal importance, validity and feasibility, and that further work is needed to test and refine the recommendations.
- DOI: http://dx.doi.org/10.1007/s11606-013-2661-4
- PubMed: http://www.ncbi.nlm.nih.gov/pubmed/24442334
Havill NL, Leeman J, Shaw-Kokot J, Knafl K, Crandell J, Sandelowski M. Managing large-volume literature searches in research synthesis studies. Nurs.Outlook. Epub 2013 Nov 13. PMID: 24345615.
BACKGROUND: Systematic reviews typically require searching for, retrieving, and screening a large volume of literature, yet little guidance is available on how to manage this volume.
PURPOSE: We detail methods used to search for and manage the yield of relevant citations for a mixed-methods, mixed research synthesis study focused on the intersection between family life and childhood chronic physical conditions.
METHODS: We designed inclusive search strings and searched nine bibliographic databases to identify relevant research regardless of methodological origin. We customized searches to individual databases, developed work-arounds for transferring large volumes of citations and eliminating duplicate citations using reference management software, and used this software as a portal to select citations for inclusion or exclusion. We identified 67,555 citations, retrieved and screened 3,617 reports, and selected 800 reports for inclusion.
DISCUSSION/CONCLUSIONS: Systematic reviews require search procedures to allow consistent and comprehensive approaches and the ability to work around technical obstacles.