Background: Living systematic reviews (LSRs) are continually updated, as new evidence becomes available, so that the findings remain current. Intended as a complement to the Cochrane Handbook for Systematic Reviews of Interventions and MECIR requirements, the interim guidance for Cochrane LSRs was launched in April 2017. Since then, five Cochrane pilot LSRs have been undertaken and the number of Cochrane and non-Cochrane published LSRs and protocols has steadily increased. The interim guidance has been updated, following the evaluation of the Cochrane LSR pilot.

Objectives: to provide an overview of the updated guidance for Cochrane LSRs.

Methods: an initial draft of the updated guidance was informed by the current literature on LSRs; the experiences of Cochrane pilot LSR teams; and Cochrane’s evaluation of three Cochrane and three non-Cochrane pilot LSRs. Members of the Living Evidence Network were then invited to provide feedback on this draft which was used to further refine the guidance.

Results: the resulting output from this revision process is the “Guidance for Cochrane Living Systematic Reviews”. This document guides Cochrane teams through the production and publication of LSRs. Topics include:
- determining whether a review topic is suitable for an LSR approach
- differences between LSRs and other approaches to systematic reviews
- workflow, workload and authorship considerations
- describing LSR-specific methods in the protocol and the published LSR (e.g. strategies for continual evidence surveillance; criteria for when to integrate new evidence and update the LSR; criteria for when to transition the LSR out of living mode)
- technological enablers to support LSRs
- editorial and peer review considerations
- publishing updates to an LSR in the Cochrane Library
- using the Updating Classification System to communicate the status of an LSR to readers

Conclusions: the demonstrated feasibility of the Cochrane pilot LSRs has paved the way for more teams to undertake LSRs and, in turn, contribute to advancing methods associated with LSRs. Accordingly, it is anticipated that the guidance will be a living document that is regularly updated as methods for producing and publishing LSRs evolve.

Patient or healthcare consumer involvement: broadening engagement, including by consumers, is a key driver for living evidence methods. Research is underway to explore how best to enable this. As this knowledge is built, future revisions of the guidance will both describe how best to involve consumers and engage healthcare consumers in the process of refining the guidance.

This abstract was submitted on behalf of the Living Evidence Network.