Rapid reviews in rapid learning health systems

Article type
Authors
Klugar M1, Pokorná A2, Slezáková S1, Vrbová T3, Líčeník R1, Dušek L4, Klugarová J1
1Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech CEBHC: JBI Centre of Excellence, Masaryk GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University
2Czech National Centre for Evidence-Based Healthcare and Knowledge Translation and Department fo Nursing, Faculty of Medicine, Masaryk University
3Czech Health Research Council
4Institute of Health Information and Statistics of the Czech Republic; Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University
Abstract
Background:
In our era of information “over” saturation is a rapid essential keyword, especially in the context of health systems and health policymakers. Some policymakers prefer to inform their statements and decisions based on some evidence. Our role as systematic reviewers and Evidence-Based Healthcare advocates is that we should advocate for the best available evidence, which would ideally inform all decisions. However, the main question remains is if this evidence used by health policymakers is unbiased, not confounded and rigorously and transparently ideally synthesized. The usual answer is no. For most of the questions we do not have a high-quality rigorously and transparently developed evidence synthesis.

Objectives:
The objective of this work is to explore if the rapid review is “rapid” enough in rapid learning health systems.

Methods:
Expert evidence of systematic reviewers from Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech Centre of Evidence-Based Healthcare: JBI centre of excellence, Masaryk University GRADE Centre) supporting health policymakers by timely evidence synthesis on the national level.

Results:
There exist several equations, which are calculating how much time is needed to develop rigour unbiased synthesis of evidence. The greatest unknown in these equations is usually a number of retrieved studies after searching. However, searching itself, the search strategy and number of databases of published and unpublished studies would influence the total number of retrieved studies as well. The usual question of policymakers is: “When your team can synthesize the evidence for us?” The usual answer to this is "How much rigour would you like to have in your synthesis? It will take six months, and if we want to have a publication, probably sixteen months; or three months, if we do not search all possible databases, however still rigour enough but no “typical publication” will be possible." At this point the policymakers usually stop us and they say “we need it in a week time”. Our answer to this is “All right” if we stop to do anything else for next “24/7” and our work is “fast and dirty” the synthesis is possible and still “rigour” enough.
Conclusions:
While finishing this abstract, there are several Cochrane rapid reviews which are planned to be developed and published within two weeks of time because of the extraordinary COVID-19 pandemic. However, should not we be able to accommodate such real rapid reviews in our normal lives? Although the situation in these days is unique, our health systems need “real” rapid reviews. Hopefully, at least one positive lesson learned from the COVID-19 pandemic will be that “real” rapid reviews are possible.

Patient or healthcare consumer involvement:
It should be possible for all relevant stakeholders, including patients and healthcare consumers, to be involved in rapid review development, even this is a “real” rapid review developed and published in two weeks.