Table 1 Overview of approaches to rapid reviews according to three different policy goals and timelines
Timeline and goal | Synthesis approach to address a health policy or system issuea | Types of evidence to consider including | Project management considerations | Illustrative examples of groups that produce each type of rapid review |
|---|---|---|---|---|
Days • e.g., to inform urgent internal policy discussions and/or management decisions | Profile of existing evidence • Uses a focused question and sub-questions to guide a targeted and rapid search (often using sources for pre-appraised evidence such as Health Systems Evidence) to enable efficient identification of the most relevant evidence • Reviews in this timeline typically only conduct a policy analysisb (e.g., assessment of benefits, harms and/or costs of policy options), but systems analysis may be feasible depending on the scope. • A structured profile consisting of tables that map and summarize the identified literature (e.g., according to themes or domains of interest) along with a brief narrative summary of the types of documents found and their focus typically forms the final review. | • Evidence from systematic reviews o Overviews of systematic reviews o Systematic reviews • Evidence from primary studies o Not typically feasible to focus on primary studies given constrained time that limits ability to conduct and review comprehensive searches and synthesize findings • Other sources of evidence o Key informant interviews may be conducted if time permits to identify additional literature and insights about the topic (depends on the timeline and availability of key informants) o Not typically feasible to include other types of evidence (e.g., evidence from policy documents and websites) given the time required for hand searching | • Brief consultation with a small core transdisciplinary rapid review team before and in final stage of the review to efficiently brainstorm an approach to searching, how to organize findings and to conduct the final write-up. • Review best conducted with 1–2 reviewers sharing the work to enable rapid iterations of the review (e.g., to compare evidence needed with what has been identified) • A merit review process (i.e., where policymakers, stakeholders and/or researchers review the synthesis for policy relevance and scientific merit) is typically not feasible in this timeline. | • McMaster Health Forum (also conducts reviews in weeks or months) [15, 29] • Canadian Agency for Drugs and Technologies in Health (also conducts reviews in weeks or months) [20] • K2P Centre (also conducts reviews in weeks or months) [2] |
Weeks • e.g., to inform public debates | Summary • May use a mix of policy, systems and political analysis • Review includes a summary of key findings in tabular format that may be organized by an existing thematic framework (e.g., by a typology of approaches and/or outcome domains) • Tables are typically accompanied by a brief narrative summary that highlights key findings and themes or a summary of whether and how a policy option has been used in a small number of jurisdictions (i.e., for a systems analysis) • A timeline of weeks typically does not allow for a true synthesis of findings, which would require a combination of or re-analysis of findings from the literature through quantitative methods or qualitative thematic or framework analysis | • Evidence from systematic reviews (same as above) • Evidence from primary studies o Targeted searches of a small number of highly relevant databases (searches are sometimes narrowed by country focus depending on the scope of the question) o A reanalysis of primary studies from systematic reviews (e.g., existing systematic reviews that address broad questions can provide a short-cut to identifying relevant studies for narrower rapid review question) • Other types of evidence o Key informant interviews can be conducted to identify additional literature and insights about the topic, but with more stakeholders than what is feasible in the previous row o Targeted hand searches for policy documents and websites to conduct a system and/or political analysis related to a small number of comparator jurisdictions | • Brief consultation with a small core transdisciplinary rapid review team before and in final stage of the review to efficiently brainstorm an approach to searching, how to organize findings and to conduct the final write-up. • Review may be best conducted with larger team that can apply standardized procedures to review search results and extract data from included documents • Some members of the review team can be deployed to conduct hand searches for policy documents and websites (e.g., to inform a targeted system analysis that includes a small number of comparator jurisdictions) • A merit review process can be completed within this timeframe in order to receive feedback from policymakers, stakeholders and researchers about policy relevance and scientific rigor. | • All examples from previous row • EVIPNet Chile [3] |
Months • e.g., to inform policy development cycles that have a longer timeline, but that cannot wait for a traditional full systematic review | Synthesis • Typically incorporates multiple types of analyses (e.g., policy, systems and political analysis) and applies an evolving framework to synthesize findings • With the longer timeline a synthesis may involve generating analyses from a broader policy domain and from across more jurisdictions for systems and policy analyses, as well as integrating (i.e., synthesizing) the findings from these analyses using an evolving framework that is generated based on emerging concepts from the literature and insights from key informants • An initial framework may come from existing theories as a “best fit” for analysis (e.g., when the review addresses a question that draws on a well-established literature with a specific discipline) or derived from consultations with the requestors and/or key informants to use for the analysis (e.g., when the review questions are transdisciplinary and an overarching framework is unlikely to exist) | • Evidence from systematic reviews (same as above) • Evidence from primary studies o Broader searches and in more databases o Update of systematic reviews (e.g., where a review on the same topic exists, but is out-of-date) o Reanalysis of primary studies from systematic reviews by applying inclusion criteria from the rapid review question to a previously conducted systematic review to generate a set of relevant studies to re-analyze but with a different or narrower focus (note that this could accompany an update a systematic review) • Other types of evidence o Key informant interviews, but with more stakeholders than what is feasible in the previous row o Broader hand searches for policy documents and websites to conduct a system and/or political analysis related to a larger number of comparator jurisdictions | • Brief consultation with a small core transdisciplinary rapid review team before and in final stage of the review to efficiently brainstorm an approach to searching, how to generate findings and to conduct the final write-up. • Review may be best conducted with a small review team in order to allow for more in-depth interpretation and iteration | • All examples from first row • EPPI-Centre • Evidence Check (Sax Institute) [22] • Evidence Alliance [32] • African Centre for Evidence |