Fit for purpose: Perspectives on rapid reviews from end-user interviews

Lisa Hartling, Jeanne Marie Guise, Susanne Hempel, Robin Featherstone, Matthew D. Mitchell, Makalapua L. Motu'apuaka, Karen A. Robinson, Karen Schoelles, Annette Totten, Evelyn Whitlock, Timothy J. Wilt, Johanna Anderson, Elise Berliner, Aysegul Gozu, Elisabeth Kato, Robin Paynter, Craig A. Umscheid

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: There is increasing demand for rapid reviews and timely evidence synthesis. The goal of this project was to understand end-user perspectives on the utility and limitations of rapid products including evidence inventories, rapid responses, and rapid reviews. Methods: Interviews were conducted with key informants representing: guideline developers (n = 3), health care providers/health system organizations (n = 3), research funders (n = 1), and payers/health insurers (n = 1). We elicited perspectives on important characteristics of systematic reviews, acceptable methods to streamline reviews, and uses of rapid products. We analyzed content of the interview transcripts and identified themes and subthemes. Results: Key informants identified the following as critical features of evidence reviews: (1) originating from a reliable source (i.e., conducted by experienced reviewers from an established research organization), (2) addressing clinically relevant questions, and (3) trusted relationship between the user and producer. Key informants expressed strong preference for the following review methods and characteristics: use of evidence tables, quality rating of studies, assessments of total evidence quality/strength, and use of summary tables for results and conclusions. Most acceptable trade-offs to increase efficiencies were limiting the literature search (e.g., limiting search dates or language) and performing single screening of citations and full texts for relevance. Key informants perceived rapid products (particularly evidence inventories and rapid responses) as useful interim products to inform downstream investigation (e.g., whether to proceed with a full review or guideline, direction for future research). Most key informants indicated that evidence analysis/synthesis and quality/strength of evidence assessments were important for decision-making. They reported that rapid reviews in particular were useful for guideline development on narrow topics, policy decisions when a quick turn-around is needed, decision-making for practicing clinicians in nuanced clinical settings, and decisions about coverage by payers/health insurers. Rapid reviews may be more relevant within specific clinical settings or health systems; whereas, broad/national guidelines often need a traditional systematic review. Conclusions: Key informants interviewed in our study indicated that evidence inventories, rapid responses, and rapid reviews have utility in specific decisions and contexts. They indicated that the credibility of the review producer, relevance of key questions, and close working relationship between the end-user and producer are critical for any rapid product. Our findings are limited by the sample size which may have been too small to reach saturation for the themes described.

Original languageEnglish (US)
Article number32
JournalSystematic reviews
Volume6
Issue number1
DOIs
StatePublished - Feb 17 2017

Bibliographical note

Funding Information:
This manuscript is based on a project conducted by a working group within the Evidence-based Practice Center Program supported by the Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland, through contracts to the following Evidence-based Practice Centers: University of Alberta (290-2012-00013-I), Blue Cross Blue Shield (290-2012-00010-I), ECRI Institute-Penn Medicine (290-2012-00011-I), Kaiser (290-2012-00015-I), The Johns Hopkins University (290-2012-00007-I), and the Scientific Resource Center for the EPC Program (290-2012-00004-C). The findings and conclusions in this manuscript are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

Publisher Copyright:
© 2017 The Author(s).

Keywords

  • Decision-makers
  • End-users
  • Interviews
  • Knowledge synthesis
  • Rapid reviews
  • Systematic reviews

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