Rapid reviews can increase use of evidence by health system decision-makers’ with fast-paced needs: the VA ESP experience

Article type
Authors
Peterson K1, Floyd N1, McCleery E1, Christensen V1, Helfand M1
1Veterans Affairs Evidence-based Synthesis Program, USA
Abstract
Background: In response to continued growth in use of rapid reviews, various evidence synthesis organizations have undertaken efforts to better understand the range of products offered and approaches used to abbreviate the review process, evaluate how usability may differ from standard systematic reviews, and assess end-user perspectives on acceptability and impact.
In an effort to increase use of evidence for Veterans Health Administration’s (VHA) fast-paced decision-making needs, the Veterans Affairs Evidence-based Synthesis Program (VA ESP) began producing rapid reviews in October 2012. We seek to build on previous work by describing our unique view on flexibility and evaluating VHA end-user satisfaction and impact of our rapid reviews on VA health system decision-making when used as the alternative to no evidence, rather than to standard systematic reviews.
Objective: Describe rapid review activity and summarize VHA end-user feedback.
Methods: Analyze rapid reviews produced during fiscal years 2012 through 2015 and describe types of topics and policy-maker needs addressed and unique approaches to flexibility.
Use descriptive statistics and narrative methods to summarize VHA end-user feedback on: 1) satisfaction with process and product; 2) clarity of key messages; 3) decision-making process characteristics; and 4) extent to which the report influenced decisions.
Results: To date, reviews have primarily addressed process of care (43%) and access (29%) topics and systems policy initiative needs (67%). Examples of our flexibility include incorporation of: 1) primary analysis of VA or other data sets to confirm or expand rapid review findings; and 2) descriptive context about related innovations. Potential limitations of our experiences are that they may have limited applicability to healthcare settings outside the VA and end-user feedback may be limited by recall bias due to retrospective data collection.
Conclusions: Feedback from VHA rapid review end-users will help address knowledge gaps in how rapid reviews can support fast-paced decision-making needs as an alternative to no evidence, rather than to a standard systematic review.