Protocol for a Rapid Evidence Review of Traditional and Complementary Medicine for People with Diabetes Receiving Palliative or End-of-Life Care

Abstract

Abbreviations: T&CM, traditional and complementary medicine;PICO, patient/population/problem, intervention, comparison, outcome; UK, united kingdom; USA, united states of America; SR, systematic reviews; AMED, allied and complementary medicine database IntroductionThis paper presents a protocol using rapid review methods that will be used to select a limited number of traditional and complementary medicine (T&CM) interventions and evaluate the available evidence. The results from this review will be used to inform an update of the Australian Guidelines for Managing Diabetes at the end of life (Guidelines). Rapid review methods were chosen to maximise the number of T&CM interventions and different problems that could realistically be reviewed in a timely manner given the resources available to the research team.Rapid review methods are increasingly used as an alternative to systematic reviews (SR) when there are time, resource or other logistical constraints.1-5 Estimated costs of a comprehensive SR exceed USD$100,000 with an average of 1,139 hours to complete. 6For many research teams, pragmatic decisions must be made that may compromise the accepted 'gold standard' systematic review methods used to minimise bias, which in turn impacts the validity and generalisability of the results. As such, a rapid review is not a replacement for a full systematic review and meta-analysis. Notwithstanding methodological constraints, rapid reviews should endeavour to be transparent, systematic and reproducible. 4 Most Rapid Reviews do not publish a protocol.3 However, the recent establishment of a Cochrane Rapid Reviews Methods Group highlights the need to develop methods that minimise bias despite project constraints. Outlining the objectives and methodology a priori will further improve the transparency and quality of the methods used to frame the review questions, help reduce bias arising from the rapid review study design, and enhance the reproducibility of the results. AbstractBackground: Rapid review methods are increasingly used as an alternative to systematic reviews when there is time, resource or other logistical constraints. The Cochrane Rapid Reviews Methods Group recommends further methodological development and publishing protocols to improve the transparency and quality of the review. The authors of this paper were invited to provide timely, expert input for the revision of the 2010 Guidelines for Providing Palliative and End of Life Care for People with Diabetes (Guidelines), Australia, regarding the evidence-based use of traditional and complementary medicine (T&CM). The inclusion and consideration of T&CM in guidelines is often ad-hoc and would benefit from more systematic methods. Evidence of efficacy on clinical outcomes is not the only reason to review an intervention. Other reasons relevant to the T&CM context is: interventions that are commonly used by people with diabetes in the palliative care setting, have potentially high costs or risks, or present a conflict in choices between individual and societ...