Enhancing the efficiency of the systematic review process for evidence-based medicine

Article type
Authors
Crawford C1, Jonas W1
1Samueli Institute, USA
Abstract
Background: Systematic reviews are widely recognized as the best means of synthesizing clinical research; however traditional approaches can be costly and time-consuming and are often subject to selection and judgment bias. It can be difficult to interpret the results of a systematic review in ameaningful way in order to make research recommendations or clinical decisions about implementation.

Objectives: In order to maximize efficiency in the execution and dissemination of synthesized literature, there is a need for a streamlined, coordinated international effort among researchers and healthcare professionals to provide regular, up to date, objective, high quality information on healthcare practices, interventions and treatments.

Methods: Samueli Institute has developed a systematic review process known as the Rapid Evidence Assessment of the Literature (REAL  c ) that not only makes the systematic review process more reliable and objective but also streamlines the process without compromising quality.

Results: The REAL uses a clearly described and reliably applied set of steps embedded in standard rule books and customized, automated software for efficient evaluation and remote subject matter expert input.

Conclusions: The efficiency of the REAL process is such that it can facilitate the conduct of rigorous, high quality, transparent evidence-based systematic reviews more rapidly (approximately half the time) and at lower cost (approximately 30–50% less) than other standard methods. In addition to increased efficiency, the REAL process incorporates an assessment of the overall literature pool and its current implications for research and practice. Thus, a REAL provides a basis allowing subject matter experts to determine the quality of the research as a whole, gaps in the literature, effectiveness of the intervention, the confidence in that effectiveness estimate, and the appropriateness of clinical use of the intervention. Using this process enables researchers, clinicians and patients to be better informed as to the current state-of-the-science for any intervention.