Article type
Year
Abstract
Background: WHO uses the best available evidence to inform its policies and technical guidance, and to guide program implementation. The WHO Incident Management Team (IMT) for COVID-19 required rapid identification of research studies to inform daily strategic decisions as well as its normative guidance.
Objectives:To describe the approach for prioritizing and coordinating rapid reviews, and the characteristics of the reviews performed in response to the COVID-19 outbreak.
Methods: The WHO Rapid Review Team (RRT) emerged in an organic manner, with one technical staff person soliciting topics for reviews starting early February 2020. This evolved into a small team of experienced reviewers who responded to ad hoc requests for answers to specific questions from WHO staff in the IMT and other technical units. In addition, the RRT commissioned rapid reviews from external review teams, using a list of prioritized questions from IMT.
Results: At the time of writing, 16 rapid reviews were commissioned from external teams and 3 were performed by RRT members. An additional 4 topics were reviewed in brief by RRT members. Topic scope ranged from very broad (e.g. quarantine) to very focused (e.g. single drugs such as remdesivir). The 16 external reviews took 5-10 days to produce by teams ranging in size from 5 to 30 members; reports ranged in length from 8 to 150 pages. Chinese-language literature was reviewed in most reviews; pre-prints were rarely included. Indirect evidence from diseases caused by other coronaviruses or from influenza was used in 15 of the 16 external reviews. The quality of the reviews was uniformly high as assessed with AMSTAR 2. The most common deviations from full systematic reviews were: 1) searching of a limited number of bibliographic databases; 2) lack of dual title and abstract screening; 3) abbreviated quality assessments at the study level; and 4) exclusively qualitative summaries.
Challenges included: 1) difficulty engaging busy key IMT staff to guide prioritization and formulation of review key questions; 2) coordination of ad hoc requests for reviews coming from multiple sources within WHO; and 3) managing expectations of IMT members regarding feasible scope and timelines for high-quality reviews.
For the efficient and optimal use of evidence to inform WHO guidance in this continuing outbreak and in for future emergencies there is a need: 1) to identify multiple members of the IMT with varied expertise who have the capacity to respond to urgent requests from the RRT; 2) for training and socialization of rapid review methods between emergencies; 3) to have standard operating procedures in place prior to the onset of an emergency; and 4) to have a cadre of rapid review teams “on call” in the event of emergencies.
Conclusions: The RRT coordinated a large number of high-quality reviews within a short period of time. It was challenging to orchestrate with busy IMT staff and to manage expectations. Detailed planning is needed between emergencies for the optimal implementation of a RRT.
Objectives:To describe the approach for prioritizing and coordinating rapid reviews, and the characteristics of the reviews performed in response to the COVID-19 outbreak.
Methods: The WHO Rapid Review Team (RRT) emerged in an organic manner, with one technical staff person soliciting topics for reviews starting early February 2020. This evolved into a small team of experienced reviewers who responded to ad hoc requests for answers to specific questions from WHO staff in the IMT and other technical units. In addition, the RRT commissioned rapid reviews from external review teams, using a list of prioritized questions from IMT.
Results: At the time of writing, 16 rapid reviews were commissioned from external teams and 3 were performed by RRT members. An additional 4 topics were reviewed in brief by RRT members. Topic scope ranged from very broad (e.g. quarantine) to very focused (e.g. single drugs such as remdesivir). The 16 external reviews took 5-10 days to produce by teams ranging in size from 5 to 30 members; reports ranged in length from 8 to 150 pages. Chinese-language literature was reviewed in most reviews; pre-prints were rarely included. Indirect evidence from diseases caused by other coronaviruses or from influenza was used in 15 of the 16 external reviews. The quality of the reviews was uniformly high as assessed with AMSTAR 2. The most common deviations from full systematic reviews were: 1) searching of a limited number of bibliographic databases; 2) lack of dual title and abstract screening; 3) abbreviated quality assessments at the study level; and 4) exclusively qualitative summaries.
Challenges included: 1) difficulty engaging busy key IMT staff to guide prioritization and formulation of review key questions; 2) coordination of ad hoc requests for reviews coming from multiple sources within WHO; and 3) managing expectations of IMT members regarding feasible scope and timelines for high-quality reviews.
For the efficient and optimal use of evidence to inform WHO guidance in this continuing outbreak and in for future emergencies there is a need: 1) to identify multiple members of the IMT with varied expertise who have the capacity to respond to urgent requests from the RRT; 2) for training and socialization of rapid review methods between emergencies; 3) to have standard operating procedures in place prior to the onset of an emergency; and 4) to have a cadre of rapid review teams “on call” in the event of emergencies.
Conclusions: The RRT coordinated a large number of high-quality reviews within a short period of time. It was challenging to orchestrate with busy IMT staff and to manage expectations. Detailed planning is needed between emergencies for the optimal implementation of a RRT.