Keeping up and keeping pace with the Evidence, COVID-19 lessons learned

Article type
Authors
waddell L1
1Public Health Agency of Canada
Abstract
Background: Since the world was alerted to the SARS-COV-2 outbreak in Wuhan China there has been a scramble to monitor and publish on the epidemic, predict its spread, study the virus, transmission patterns, clinical presentation and disease. The challenge for public health organizations is keeping up with the rapidly evolving literature.

Objectives: Identify, categorize and briefly summarize the literature on SARS-COV-2 / COVID-19 on a 24-hour cycle to facilitate accurate and up to date information flow to decision makers.

Methods:A protocol for the systematic identification, classification, dissemination and maintenance of information on SARS-COV-2 was designed to run on a 24-hour cycle, 5 days per week. A daily literature search was initiated and pulled new citations from 10 bibliographic databases, preprint databases and coronavirus dashboards set-up by prominent publishers. New citations were added to a citation management software, and duplicates were removed or updated as citations moved from preprint to accepted peer-reviewed publications. Reviewers were assigned to read, classify and provide a brief synopsis of key outcomes in each manuscript, which were compiled into a daily report. Daily reports were compiled into a filterable and searchable running list of daily reports. Read/export access to the citation database was also made available to end-users for personal referencing or exploration.

Results:Seven people were trained to work on this project part-time to facilitate quick daily dissemination of emerging literature. Standard topic categories were developed and used consistently throughout the project and each citation was tagged into one or more categories. Each day there were 20 to 150 new citations to review and summarize. By March 3, 2020 there were over 900 citations on SARS-COV-2 captured through this process. The topic areas with the most literature include clinical data (n=203), epidemiology (177), predictive models (160) and coronavirology (116). There was also a substantial number of articles on transmission (n=51), diagnostics (73), therapeutics (64), and vaccines (13). To manage on-going information needs, data extraction tools were developed for key epidemiological and clinical parameters, and topic specialists maintained up-to-date summaries on public health intervention research, healthcare intervention research, vaccines and therapeutics. Other outcomes were summarized on an as needed basis. Additional topic based summaries were developed from the SARS-COV-2 literature as required.

Conclusions: Linking together synthesis expertise with varying backgrounds across our organisation prevented duplication of efforts. This improved the speed and efficiency of accurate responses to decision makers and lead to persons with appropriate expertise responding to inquiries. Our experience highlights the use of synthesis research principles during an epidemic to support rapidly evolving evidence-based decision-making in a timely manner.

Patient or healthcare consumer involvement: none