Finding best available evidence in a time of crisis

Article type
Authors
Mann M1, Byrne A1, Harrop E1, Selman L2
1Cardiff University
2University of Bristol
Abstract
Background: Systematic reviews represent a robust methodology to synthesize research evidence. However, they can be time- and resource-intensive. During the COVID-19 pandemic, rapid reviews have been important to produce evidence to inform policy and clinical practice in a timely manner. However, rapid reviews may be susceptible to bias through using methodological shortcuts or not adhering to a specified methodology.

Objectives: To report on a rapid review conducted during the COVID-19 pandemic on how to best support large numbers of bereaved people, to demonstrate how evidence can be gathered at pace and impact quickly on palliative care practice and policy.

Methods: We followed Palliative Care Evidence Review Service (PaCERS) methodology [1], developed to conduct rapid reviews requested by clinical services, with a narrative synthesis. A systematic search was conducted on four databases and supplementary search methods were employed to identify additional papers. Two reviewers carried out study selection independently. Data extraction and quality assessment was completed independently by one reviewer and checked for accuracy by a second reviewer.
Results: Six studies were included, reporting on system responses to man-made disasters and natural disasters. A narrative synthesis approach was used to synthesize the data from the available evidence. The review was completed in 10 weeks and rapidly published in a peer-reviewed journal adding to the emergent COVID-19 literature. The review informed the successful funding application and project design for a UK-wide study and was used in developing a national bereavement framework for Wales.
Conclusions: Rapid, trustworthy evidence syntheses to inform policy and clinical practice are achievable. Our review highlighted common features of effective bereavement service delivery during and beyond a pandemic, which will have a long-lasting impact.

Patient or healthcare consumer involvement:
Even though consumers were not involved in this study, they were part of the review advisory group in our rapid review Programme.

1. Mann, M., Woodward, A., Nelson, A., Byrne, A. (2019). Palliative Care Evidence Review Service (PaCERS): a knowledge transfer partnership. Health Research Policy and Systems, 17(1), 100. doi:10.1186/s12961-019-0504-4