Article type
Abstract
Background: It often takes years before practice-changing evidence published in randomised trials reaches patients in routine clinical practice. Contributing factors include the prolonged time it takes for guideline organisations to update their recommendations, and lack of supporting tools for shared decision making. In response, we have created WikiRECS, including the pre-eminent BMJ RapidRecs project.
Objectives: Faced with potentially practice-changing evidence, we aim to, within 90 days, create and disseminate trustworthy recommendations, evidence summaries and consultation decision aids addressing important topics in: 1) a novel, user-friendly, single-page synopsis format; and, 2) digitally structured multi-layered presentation formats on the MagicApp (www.magicapp.org).
Methods: We screen new evidence daily through a tailored system, developed in partnership with McMasterPLUS, that identifies the most relevant and newsworthy research. After a topic is chosen, we recruit a full guideline panel with no relevant financial and minimal intellectual interests. The panel, including patients, content experts, methodologists and frontline clinicians finalise the PICO question. A parallel team performs systematic reviews addressing relative effects, baseline risk, and values and preferences as necessary, within 45 days. The panel then considers the evidence and makes recommendations. GRADE and IOM standards provide a framework for each step in the process. The recommendation and evidence synopsis, and its supporting systematic reviews, is published in one or more journal(s).
Results: In the first 6 months, we have completed 3 BMJ RapidRecs, 2 WikiRecs, with several more planned or in preparation. All supporting evidence is accompanied by interactive infographics, GRADE summary of findings, and decision aids for the clinical encounter.
Conclusion: Multidisciplinary teams can produce trustworthy recommendations, presented in understandable formats that are easily accessible by patients and clinicians, in a very short timeframe. This approach demonstrates potential synergies between evidence synthesis, appraisal and dissemination within the evidence ecosystem.
Objectives: Faced with potentially practice-changing evidence, we aim to, within 90 days, create and disseminate trustworthy recommendations, evidence summaries and consultation decision aids addressing important topics in: 1) a novel, user-friendly, single-page synopsis format; and, 2) digitally structured multi-layered presentation formats on the MagicApp (www.magicapp.org).
Methods: We screen new evidence daily through a tailored system, developed in partnership with McMasterPLUS, that identifies the most relevant and newsworthy research. After a topic is chosen, we recruit a full guideline panel with no relevant financial and minimal intellectual interests. The panel, including patients, content experts, methodologists and frontline clinicians finalise the PICO question. A parallel team performs systematic reviews addressing relative effects, baseline risk, and values and preferences as necessary, within 45 days. The panel then considers the evidence and makes recommendations. GRADE and IOM standards provide a framework for each step in the process. The recommendation and evidence synopsis, and its supporting systematic reviews, is published in one or more journal(s).
Results: In the first 6 months, we have completed 3 BMJ RapidRecs, 2 WikiRecs, with several more planned or in preparation. All supporting evidence is accompanied by interactive infographics, GRADE summary of findings, and decision aids for the clinical encounter.
Conclusion: Multidisciplinary teams can produce trustworthy recommendations, presented in understandable formats that are easily accessible by patients and clinicians, in a very short timeframe. This approach demonstrates potential synergies between evidence synthesis, appraisal and dissemination within the evidence ecosystem.