Background:

Organizations depend on useful and methodologically rigorous systematic reviews (SRs) when developing new, updated, or living guidelines (LGs). Many have found employing in-house systematic reviewers to be an efficient and cost-effective option for obtaining evidence, particularly when producing LGs requiring regular literature updates. In-house SR teams face potential challenges to maintaining research integrity and producing unbiased reports when employed by mission-driven organizations. When challenges are acknowledged and strategies to mitigate their impact are enacted, in-house SR teams and guideline teams can increase opportunities for collaboration and communication that are often limited in contract-model relationships.

Objectives:

To describe potential challenges facing in-house SR teams, mitigation strategies for maintaining research integrity, and opportunities for synergy when research teams and guideline producers work closely together.

Methods:

In January 2022, we began the multi-year process of building an in-house SR program by assembling a team of experienced systematic reviewers and a research librarian. We identified potential challenges to maintaining research integrity that were largely related to either working for a mission-driven organization with well-defined interests, an imbalance in power, or the combination (e.g., decisions made without influence from the guideline team; the possibility of real/perceived or overt/subtle consequences for unpopular decisions).
The SR team and guideline team applied a modified GIN-McMaster Checklist that was specific to our organization’s guideline development process to discuss the potential challenges and mitigation procedures. Outcomes were agreed-upon points of interaction or independence to maximize communication and collaboration without compromising research integrity.

Results:

Solutions address communication, education, and collaboration between the SR team and guideline team. Processes safeguard against overreach of each team into the other’s scope of responsibilities and allow the SR team to maintain scientific independence, capitalize on a shared understanding of organizational priorities, acknowledge the complex nature of considering organizational priorities in designing research scope, and facilitate presentation of findings tailored to the needs of the guideline team.

Conclusions:

Transparent communication, education, and collaboration create an environment for research integrity and synergy between the SR and guideline teams, resulting in guideline recommendations rooted in evidence and optimized for use by the mission-driven organization’s audience of patients, providers, and policymakers.