Rapid reviews versus full systematic reviews: An inventory of current methods and practice in health technology assessment

Abstract

Objectives:This review assessed current practice in the preparation of rapid reviews by health technology assessment (HTA) organizations, both internationally and in the Australian context, and evaluated the available peer-reviewed literature pertaining to the methodology used in the preparation of these reviews.Methods:A survey tool was developed and distributed to a total of fifty International Network of Agencies for Health Technology Assessment (INAHTA) members and other selected HTA organizations. Data on a broad range of themes related to the conduct of rapid reviews were collated, discussed narratively, and subjected to simple statistical analysis where appropriate. Systematic searches of the Cochrane Library, EMBASE, MEDLINE, and the Australian Medical Index were undertaken in March 2007 to identify literature pertaining to rapid review methodology. Comparative studies, guidelines, program evaluations, methods studies, commentaries, and surveys were considered for inclusion.Results:Twenty-three surveys were returned (46 percent), with eighteen agencies reporting on thirty-six rapid review products. Axiomatic trends were identified, but there was little cohesion between organizations regarding the contents, methods, and definition of a rapid review. The twelve studies identified by the systematic literature search did not specifically address the methodology underpinning rapid review; rather, many highlighted the complexity of the area. Authors suggested restricted research questions and truncated search strategies as methods to limit the time taken to complete a review.Conclusions:Rather than developing a formalized methodology by which to conduct rapid reviews, agencies should work toward increasing the transparency of the methods used for each review. It is perhaps the appropriate use, not the appropriate methodology, of a rapid review that requires future consideration.

Organisational support for nurses in acute care settings: a rapid evidence review

“…Whilst not providing definitive evidence for an overall solution to the challenge of supporting staff, it does signal that the combination of emotionally intelligent leadership with particular approaches to staff support which are congruent with the work setting, have the potential to reduce the emotional burden on staff and improve patient care. One of the purposes of an REA is to provide evidence-based recommendations for healthcare practices and policies, [26] and the present review has highlighted three main areas that need attention in this respect.…”

“…[25] The use of REA is increasing, driven in the main, by the need to engage policy makers, healthcare professionals, and consumers in a timely manner to provide evidence-based recommendations for healthcare practices and policies. [26] A REA can be completed in a shorter period of time than a systematic review, from three weeks to six months for example, [27] and the review reported here was conducted over three months. In order to do this some concessions were made, for example hand searching of journals and textbooks was not undertaken to the same extent as would be the case in a full systematic review, and the "grey" literature was not searched.…”

“…Although there is no standardised methodology for undertaking a rapid review, [26] they have been conducted in a range of policy areas including housing, [30] alcohol and criminal harm, [31] international development, [32] improving health literacy, [33] end of life care, [34] and in reviewing health improvement strategies. [35] They provide timely information to inform practice, however they are not a quick fix, and there should be no compromise on the quality of searching, critical appraisal or analysis.…”

Implementation of systematic reviews in EFSA scientific outputs workflow

“…Criteria about what constitutes a rapid review and what shortcuts are taken to ensure that the review is rapid are not standardised. In a study of institutions using rapid reviews to support policy making, a major difference between systematic reviews and rapid reviews was that fewer sources were used when searching the literature to identify relevant studies (Watt et al, 2008a). Searching the grey literature and hand searching were the most commonly omitted steps in rapid reviews compared to systematic reviews.…”

“…For example, in a study of 36 rapid reviews, none excluded systematic reviews; 6% excluded randomized controlled trials (RCTs); 17% excluded nonrandomized controlled trials; and 83% excluded case series (Watt et al, 2008a). In contrast, no full systematic review excluded RCTs, only 8% excluded nonrandomized studies, and 31% excluded case series (Watt et al, 2008a). With respect to the outcomes considered, rapid reviews are more likely to restrict the number of outcomes considered, and in health care, the outcomes omitted by rapid reviews have tended to be social and economic rather than clinical outcomes (Watt et al, 2008a).…”