Writing a Cochrane Review update: getting started and challenges to overcome

Tags: Oral
Carter E1, Elstub L2, Wallace S2, Vale L2
1Cochrane UK, 2Cochrane Incontinence

Background:

Cochrane Reviews updates can appear a daunting undertaking for new review authors. There are multiple stages which may not be immediately apparent: revisiting the protocol, updating the search, piloting revised eligibility criteria, inclusion assessments, piloting (revised) data collection forms, application of GRADE to assess the certainty of the body of evidence and rewriting the main text. Updating reviews is vital to maintain the Cochrane Library. The promise of mentorship and support of a Cochrane Review Group (CRG) can act as a strong motivator for a variety of new review authors to get involved with Cochrane.

Objectives:

To provide a troubleshooting guide and helpful tips for a new review author updating a review.

Methods:

Using our current work on a Cochrane review update as a case study, we discuss key components of the process, challenges faced, solutions, and lessons learned.

Results:

The advantage of updating an intervention review include the opportunity, with the benefit of new patient and consumer involvement, to ensure that the study question, comparisons and outcomes remain clinically pertinent in the light of new research. New review methods may now be in use that were not in place for the original review, including risk of bias assessment and GRADE, and a relevant core outcome set may now be available. Targeting these issues will enhance the review quality.

Challenges include: the time-consuming process of revisiting the original study papers to produce a full risk of bias assessment or extract data on a new outcome; loss of data such as original data extraction forms or translated papers; engagement of the original study authors with the update; and the potential volume of combined new and old studies. Synthesis of new and existing data in light of revised comparisons and outcomes requires careful planning.

Conclusion:

Our troubleshooting guide and helpful tips focus on the specific challenges faced for review updates. These are a helpful way for new review authors to get involved with Cochrane, providing the opportunity for comprehensive systematic reviewing training with the support of a CRG within an established organisation. Review authors will additionally benefit from recognised training courses and the Cochrane Library of resources, fostering a culture of lifelong involvement.

By encouraging new reviewers to get involved with Cochrane and supporting them through the review process, the organisation will be diversified internationally, particularly in relation to the engagement of those with restrictions on their time, e.g. clinicians, who provide valuable guidance with steering the direction of future research. This enables continuing worldwide clinical input into CRGs, who may benefit from the use of technology initiatives such as Covidence and RevMan Web.