Article type
Abstract
Background:
Systematic reviews (SRs) and other evidence syntheses have established roles in evidence-based decision-making. A public health emergency presents a unique situation in which evidence is evolving too quickly for SRs to support decision-making and strategies for rapid living syntheses are needed. The 2022 mpox outbreak is used to examine the value and quality of new SRs in the early stages of a public health emergency, and a novel framework for a living evidence profile (LEP) will be presented.
Methods:
A search was conducted up to December 2022 to identify human mpox evidence syntheses prior to May 2022 (historical) and after May 2022 (new). AMSTAR 2 and PRISMA checklists were used to assess methodological and reporting quality. The novel LEP framework was implemented as a continuous process of a twice-weekly search; study selection; categorization and data extraction; integration and synthesis; weekly peer review; and LEP dissemination to stakeholders.
Results:
Two historical SRs and 24 new evidence syntheses were identified; median time from search to publication was 33 and 7 weeks, respectively; and there were duplicated outcomes across reviews. Evaluation of new syntheses suggested minimal added value, with 8% reporting only historic evidence and 58% merging new and historic evidence, of which only 33% contrasted findings. Methodological quality was critically low (100%, 92%) or low (0%, 8%), and reporting quality was poor, with a median of 16 (range 16 to 16) and 14 (5 to 22) PRISMA items not reported for historical and new syntheses, respectively. In contrast, the mpox LEP was produced weekly for the first 6 months of the outbreak and continuously captured and integrated primary research as it was published to provide insight on what was known and unknown for public health decision-makers in real time.
Conclusions:
Many mpox evidence syntheses overlapped in content, were outdated at the time of publication, and had poor adherence to methodological and reporting guidelines, thus providing minimal value to decision-makers during the mpox emergency. In our experience, the weekly LEP was an effective synthesis product to support decision-making and addressed the challenge of new evidence constantly reshaping our knowledge base.
Systematic reviews (SRs) and other evidence syntheses have established roles in evidence-based decision-making. A public health emergency presents a unique situation in which evidence is evolving too quickly for SRs to support decision-making and strategies for rapid living syntheses are needed. The 2022 mpox outbreak is used to examine the value and quality of new SRs in the early stages of a public health emergency, and a novel framework for a living evidence profile (LEP) will be presented.
Methods:
A search was conducted up to December 2022 to identify human mpox evidence syntheses prior to May 2022 (historical) and after May 2022 (new). AMSTAR 2 and PRISMA checklists were used to assess methodological and reporting quality. The novel LEP framework was implemented as a continuous process of a twice-weekly search; study selection; categorization and data extraction; integration and synthesis; weekly peer review; and LEP dissemination to stakeholders.
Results:
Two historical SRs and 24 new evidence syntheses were identified; median time from search to publication was 33 and 7 weeks, respectively; and there were duplicated outcomes across reviews. Evaluation of new syntheses suggested minimal added value, with 8% reporting only historic evidence and 58% merging new and historic evidence, of which only 33% contrasted findings. Methodological quality was critically low (100%, 92%) or low (0%, 8%), and reporting quality was poor, with a median of 16 (range 16 to 16) and 14 (5 to 22) PRISMA items not reported for historical and new syntheses, respectively. In contrast, the mpox LEP was produced weekly for the first 6 months of the outbreak and continuously captured and integrated primary research as it was published to provide insight on what was known and unknown for public health decision-makers in real time.
Conclusions:
Many mpox evidence syntheses overlapped in content, were outdated at the time of publication, and had poor adherence to methodological and reporting guidelines, thus providing minimal value to decision-makers during the mpox emergency. In our experience, the weekly LEP was an effective synthesis product to support decision-making and addressed the challenge of new evidence constantly reshaping our knowledge base.