"...rapid reviews are a form of “knowledge synthesis in which components of the systematic review process are simplified or omitted to produce information in a timely manner." — Tricco et al, 2015
Rapid reviews (RRs) are an accelerated method across the continuum of methods in knowledge synthesis (KS). In RRs, there are a number of elements that are in common with other review types such as comprehensive expert searching strategies, use of extended search techniques such as locating grey literature, screening and data extraction, among other tasks. However, RRs are undertaken when decision-makers seek to examine urgent and emerging needs (i.e., policy or clinical urgency), new medical devices and policy. A RR is central to evidence-based decision-making in public health policy so that experts and medical officials can make use of current best evidence to make decisions.
RRs aim to meet the short term demands of decision-makers and clinicians, who ultimately need timely evidence to inform decisions. Under time and resource constraints, RRs are an alternative to systematic reviews. The RR is a method that uses shorter timeframes than for other evidence-based summaries. It provides a timely and valid view of evidence but sacrifices rigour. RRs aim to provide robust analyses of evidence in less than six weeks (sometimes four), typically requiring fewer resources and funding. Due to their rapid nature, some types of literature might not always be sought and preference may be given to the more readily available research published and written in English. RRs follow most of the same principles of systematic reviews but within a shorter time frame and in less detail. RRs have their place in the field, and have gained favour in Canada, the United States and UK within the educational, government and policy sectors.
According to research, RRs are (re)appraisals of evidence that fall somewhere between health technology assessments (HTAs), and full systematic reviews of interventions. In that sense, they are similar to scoping reviews in the educational and policy sectors. The other value derived from the RR is to place the research in an order of rigour similar to systematic reviews but with shorter, urgent timelines - in two months or less. The prominence of evidence-based medicine and its principles around synthesizing papers have led some health organizations to develop rapid methods for accessing, appraising and synthesizing the evidence. Typically, this is a slow, expensive process and not undertaken for research issues that have already been studied or where there is a lack of convincing evidence. One of the first steps is to find out what has been written and what is already known. Health librarians and biomedical researchers should consider RRs to address the need to apply the evidence more quickly without the need to conduct a full systematic review.
Rapid 'cumulation' critical but there are challenges
If the review is to be delivered in a shorter time frame or a smaller budget it may seem inevitable that it will no longer be able to remain transparent, rigorous, exhaustive and comprehensive. Featherstone et al (2015) discuss some of the issues around the rigour of rapid reviews. Some questions are worth asking about the methods used to created a RR:
What are the implications of the shortcuts implied or taken in a RR, and can we measure the impact?
Rapid reviews are increasingly undertaken to meet the demands of decision makers, who need timely evidence to inform their decisions. Under such constraints the time required to undertake a traditional systematic review may be prohibitive. Limited budgets to fund systematic reviews, may also increase pressure to fund a rapid review.
If the review is to be delivered in a shorter time frame or a smaller budget it may seem inevitable that it will no longer be able to remain transparent, rigorous, exhaustive and comprehensive. What are the implications of any shortcuts that might be taken? Can we measure the impact of such shortcuts? Which methods might be adopted when undertaking a rapid review? What do commissioners want? What is the balance between working smarter and short changing the commissioners? How do you create a team that can work together more efficiently within a shorter timescale?
Which methods should be adopted when undertaking a rapid review?
What do funders such as CIHR want in a rapid review? What is rigorous?
What is the balance between working smarter and short changing the process?
How do you create a team that can work together more efficiently within a shorter timescale? These are a few of the questions that need to be answered in an era of expedited research reviews.
In a broader sense, rapid reviews are a result of the vast knowledge economy that has developed exponentially in recent decades. The number of publishing outlets and ease of publishing in the digital era is responsible for the information explosion in medicine. The sheer amount of evidence available, coupled with rapid growth of AI tools, make it difficult and time-consuming to cumulate all of the evidence on a topic. The problem of locating many separate and similar clinical studies has led to the creation of newer forms of knowledge management such as the rapid review. Despite the concerns expressed about its methodological shortcomings, the REA is widely-used in public policy and health technology assessment.
Considerations
Does your question seem to be of the type where qualitative methods and synthesis would work just as well? where several people are not required to work closely and iteratively with the sort of timescale only available to full systematic reviews?
Is there a theoretical framework for structuring your evidence assessment? Any theory must be explicit and standardized (especially about interventions) to make predictions for specific implementations of interventions
What is required are detailed descriptions of the context of any intervention (in a downloadable format, amenable to further processing), so that reviewers/end-users can make informed decisions as to relevance
In an ideal world, end-users would be sufficiently literate that they could do the RRs themselves - or at least find their way around the literature. Some are, and workshops can 'build capacity.' But who knows if your 'evidence culture' is sufficient enought? Many organizations do not have the resources to do more than simple evaluations.
Health librarians' role in RRs
Reviewing evidence takes time and health librarians can use various techniques to help their clients. One of the key questions for health librarians is how to assist researchers in the process of planning and carrying out research, and whether rapid assessments meet their needs. This requires a range of skills, knowledge and abilities on the part of the attending health librarian, and includes topics as diverse as understanding the challenges of information retrieval in a fragmented literature and the trends associated with finding the grey literature.
Components of a rapid review
To enhance the transparency of a rapid review, documents can be designed and used to guide the process, such as:
explicit and documented search strategies
assessment protocols (design statements outlining key criteria for review)
regular, periodic assessments during and after the fact
Search strategies must be documented and used to guide searching in order to:
access research using web-based search tools and databases, informed by a range and combination of search terms
pursue particular sources suggested by librarians and colleagues
respond to requests to locate grey literature, unpublished or less widely-circulated papers and reports
Search strategies identify the range of search approaches, terms and resources that were used. Searching generates a list of potentially relevant sources, from which researchers are able to focus on their own ideas and questions.
Other elements of a rapid review
Usually a review of the academic, grey and practitioner literature includes the following five steps:
Design and conceptual clarification of rapid review
Purposeful evidence-based searching, and gathering of evidence
Assessment of what is known about policy
A critical appraisal of existing research which is "time-limited" (for relevance; then full assessment)
Validation and discussion among experts
Preparation of interim assessment, and final report
In addition, search the online and print literature as comprehensively as possible and do the following;
Collate descriptive outlines of the available evidence
Critically appraise evidence (including an economic appraisal)
Sift out studies of poor quality
Provide overview of what the evidence is saying
Quantities of literature and overall quality/direction of literature (Davies, 2003, p.18-19)
Note: Please use your critical reading skills while reading entries. No warranties, implied or actual, are granted for any health or medical search or AI information obtained while using these pages. Check with your librarian for more contextual, accurate information.
