Background: Given the increasing workload of Cochrane Review Groups and review authors, there is a need to develop an evidence-based approach for updating Cochrane reviews based on priority rather than the current arbitrary and often unmet two years.

Objectives: To develop and validate a decision tool to determine when a Cochrane review should be prioritized for updating.

Methods: We have refined and amalgamated two complementary methodologies proposed for prioritizing systematic review updates namely: i) a qualitative tool based on a broad range of updating signals including: publication of new study, information from existing studies, changes in methodology, user feedback, and clinical question; and ii) formal statistical methods which assess the inclusion of new studies and the likelihood that a review’s conclusions will change, if updated, based on the primary outcome meta-analysis within the review. Formal piloting was used to refine and test the validity and reliability of the enhanced tool based on a retrospective sample of reviews. All Cochrane reviews flagged as updated during 2009 were identified. For each of the reviews, the following data were extracted: i) whether the conclusions of the update had changed; ii) the meta-analysis of the primary outcome; and iii) the corresponding meta-analysis in the previous version of the review. In doing this, new trials added to the review in the most recent update were identified. The statistical methods (programmed using STATA macro metarank) to evaluate the quantitative signals for the need to update a Cochrane review for each meta-analysis dataset was then run on all identified meta-analyses. We then compared the results of the statistical analyses with results of the updated reviews to determine priorities for updating.

Results: The results of this formal pilot and a demonstration of the decision tool will be presented at the Colloquium.