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

被引:46
作者
Hartling, Lisa [1 ]
Guise, Jeanne-Marie [2 ]
Hempel, Susanne [3 ]
Featherstone, Robin [4 ]
Mitchell, Matthew D. [5 ]
Motu'apuaka, Makalapua L. [2 ]
Robinson, Karen A. [6 ]
Schoelles, Karen [7 ]
Totten, Annette [8 ]
Whitlock, Evelyn [9 ,10 ]
Wilt, Timothy J. [11 ,12 ]
Anderson, Johanna [2 ]
Berliner, Elise [13 ]
Gozu, Aysegul [13 ]
Kato, Elisabeth [13 ]
Paynter, Robin [2 ]
Umscheid, Craig A. [14 ]
机构
[1] Univ Alberta, Dept Pediat, ECHA 4-472,11405-87 Ave, Edmonton, AB T6G 1C9, Canada
[2] Portland VA Res Fdn, Sci Resource Ctr, AHRQ Effect Hlth Care Program, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA
[3] RAND Corp, Evidence Based Practice Ctr, 1776 Main St, Santa Monica, CA 90407 USA
[4] Univ Alberta, Alberta Res Ctr Hlth Evidence, Edmonton Clin Hlth Acad 4 486D, 11405-87 Ave, Edmonton, AB T6G 1C9, Canada
[5] Univ Penn Hlth Syst, ECRI Penn AHRQ Evidence Based Practice Ctr, 3535 Market St,Suite 50, Philadelphia, PA 19104 USA
[6] Johns Hopkins Univ, Dept Med, Baltimore, MD USA
[7] ECRI Inst, 5200 Butler Pike, Plymouth Meeting, PA 19462 USA
[8] Pacific Northwest Evidence Based Practice Ctr, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA
[9] Kaiser Permanente Northwest, Ctr Hlth Res, Kaiser Permanente Res, Affiliates Evidence Based Practice Ctr, 3800N Interstate Ave, Portland, OR 97227 USA
[10] Patient Ctr Outcomes Res Inst, 1919 M St, Washington, DC 20036 USA
[11] Minneapolis VA Ctr Chron Dis Outcomes Res, Minnesota Evidence Based Practice Ctr, 1 Vet Dr,111-0, Minneapolis, MN 55417 USA
[12] Univ Minnesota, 1 Vet Dr,111-0, Minneapolis, MN 55417 USA
[13] Agency Healthcare Res & Qual, 5600 Fishers Lane, Rockville, MD 20857 USA
[14] Univ Penn, Ctr Evidence Based Practice, 3535 Market St,Suite 50, Philadelphia, PA 19104 USA
基金
美国医疗保健研究与质量局;
关键词
Rapid reviews; Systematic reviews; Knowledge synthesis; Decision-makers; End-users; Interviews; FULL SYSTEMATIC REVIEWS; QUALITY;
D O I
10.1186/s13643-017-0425-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
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页数:11
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