Background: The evidence about COVID-19 is being produced at high speed, so it is very difficult for decision makers to keep up. It seems appropriate, then, to put into practice a novel approach able to provide the scientific community and other interested parties with up-to-date, quality evidence that is actionable, and rapidly and efficiently produced.
Objectives: To systematically assess the evidence for multiple questions relevant to COVID-19, and to update them using a living approach.
Methods: We designed a protocol for multiple parallel living systematic reviews in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched for primary studies which answer different questions related to COVID-19 using both a centralised repository (Epistemonikos database) and a manual search in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. We also searched for literature in several other sources, including grey literature and trial registries. All the evidence was organised in an open platform (L·OVE - Living OVerview of Evidence) that is continuously updated using artificial intelligence and a broad network of experts. At least two researchers independently selected studies, extracted data, and assessed the risk of bias of included studies. We synthesised data for each question using meta-analysis, when possible, and prepared Summary of Findings tables according to the GRADE approach.
Results: We compiled a list of questions by liaising with local stakeholders and consulting with clinical experts. We set a team of 56 researchers from 14 organisations, who selected their questions according to their areas of expertise. We established a central team composed of methods experts, software engineers, information specialists, project managers, professional writers and journalists. A common protocol was written for all the reviews, and individual protocols were adapted to each individual review and made public. We released a short article in plain language and a preliminary report of the review as soon as all the data had been analysed. These were widely disseminated through social networks and sent to relevant authorities. Then, we submitted the full review for publication.
Twenty days after the kickoff of the project, at the moment of submission of this abstract, 17 systematic reviews have been initiated. Six are already completed and six are finishing data extraction. Most of the reviews have needed reassessment of new evidence after completing the initial screening, and one review has needed two updates after its release. It is likely that many more reviews will be initiated in the next weeks as the COVID-19 pandemic evolves.
Conclusions: A production model of multiple living systematic reviews in the same topic is feasible with a large team of researchers, a central coordinating team, and the appropriate technological tools to streamline and manage the process.
Patient or healthcare consumer involvement: No