Article review: Rapid Evidence Reviews for Health Policy and Practice

Rapid Evidence Reviews for Health Policy and Practice. Academy Health 2015

This is a nice overview and it’s clear and well written.  The summary states:

Health policymakers in the United States and elsewhere are increasingly interested in making evidence-based policy decisions, but require assistance navigating the large volume of material in peer-reviewed and grey literature. This trend has led many organizations to identify methods for producing high-quality evidence reviews faster than traditional systematic reviews to accommodate policymakers’ timeframes. After examining several existing rapid evidence review program models and the insights of experienced evidence reviewers, we find that there are methodological and organizational strategies that may help organizations produce rapid reviews that are high quality, timely, and relevant to policymakers’ decisions.

It highlights different types of rapid reviews and different methodological approaches to speeding up reviews.  It comments on accuracy:

Recent research suggests that decisions RER reviewers make to speed up the results may not necessarily lead to lower-quality reviews.

It then spoils it a bit by this comment:

On the other hand, reviews that only search for evidence electronically may fail to identify up to half of all relevant research studies, highlighting the importance of seeking input from topical experts.

I don’t like this for two main reasons:

  • Rapid reviews are necessarily about identifying ALL the published journal articles.  As far as I am aware there is little evidence to suggest including ‘expert’s improves the results of a review – systematic or rapid!  In fact, as posted on this site previously, the harder to find articles appear to add little to an overall review.
  • Written by Peter Gøtzsche and John Ioannidis, Content area experts as authors: helpful or harmful for systematic reviews and meta-analyses? questions the use of experts, reporting: “However, as evidence based medicine has gained momentum it has become clear that expert advice is often unreliable, raising questions about the validity of including content area experts as authors. We also wonder whether the pervasive incorporation of content area experts in systematic reviews and health technology assessments signifies the taming of evidence based medicine“.

But the above is only a minor criticism.

The authors conclude with:

Policymakers have looked for ways to review HSR evidence in a rigorous yet timely fashion in order to provide the best information to inform health policy decisions. RERs attempt to meet this need. Because RER results are usually less comprehensive than those from full SRs and often carry a greater degree of uncertainty, they are not simply an alternative to conducting an SR when funding and resources are limited. Simpler review methods can keep the amount of information reviewers need to process manageable, shortening the time needed to complete those steps. RERs involve tradeoffs for efficiency that limit either the generalizability of the results or the confidence readers can place in an RER’s conclusions. However, the experience of existing RER programs suggests it is possible to tailor approaches to fit the particular topic, policy context, and time and resources available to produce insights that are both relevant and credible.”

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