how to do a rapid literature review

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Rapid Review Protocol

What is a rapid review, step 1: form/refine question, step 2: define parameters, step 3: identify biases, step 4: plan & execute search, step 5: screen & select, step 6: quality appraisal, step 7: evidence synthesis, rapid review workbook.

For articles that will be included in your review, keep track of your findings with a review matrix. Click on the image below to view a sample review matrix:

You can also download this template as a Microsoft Excel file .

How can the Health Sciences Library Help?

Health Sciences librarians can assist you with:

• Expert literature searches
• Finding protocols
• Citation management assistance
• Organizing your rapid review findings

If your database search results in too many or too few citations, please contact us! We are trained on how to craft efficient searches.

Contact your liaison librarian to schedule a consultation.

Additional Resources

• Bibliography References cited in this research guide.
• Supplemental Resources Other resources that can assist with your rapid review.

A rapid review (or rapid evidence assessment) is a variation of a systematic review   that balances time constraints with considerations in bias.

Consider your research question. Is it focused and well-defined?

After taking into account basic considerations such as the biology and physiology of the problem, its epidemiology, and the unsatisfactory clinical performance and patient outcomes that lead to interest in the topic, Haynes 3 suggests the following to further develop a research topic:

• What is the appropriate stage for evaluation?
• Can internal validity be achieved?
• To what extent is external validity achievable?
• What will your circumstances permit?
• What can you afford?
• What is the best balance between "idea" and "feasibility"?

Alternatively, Farrugia 4  summarizes two frameworks for refining research questions, FINER and PICOT.

Determine the parameters of your literature search by answering the following questions:

What resources will you search?

Databases commonly searched at VCU include PubMed , CINAHL , Web of Science , and  PsycInfo . Embase is another good resource for institutions with access to it. Popular "grey literature" resources include  clinicaltrials.gov , NIH RePORTER ,  Dissertations and Theses , and professional associations' conference proceedings. Check our  research guides for additional resources.

What will be your inclusion/exclusion criteria?

Some criteria to consider include: time period, language,  location,  age range, animal or human studies, type of published materials (e.g. randomized-control trials, cohort studies, etc.)

What will be your screening protocol?

Things to consider include:

How many reviewers will you have and who will they be? ( The  IOM  recommends a team of 2+ reviewers for systematic reviews.) 5

If you use multiple reviewers, how will disagreements between them be settled (e.g. consensus, third-party)?

The Cochrane Handbook  (7.2.3) lists specific steps to take in the screening and selection process  that could be adapted for a rapid review. 2

How will you appraise the quality of selected studies? What  tool/rubric will you use?

Many reviews employ a system similar to that developed by the Cochrane Handbook for assessing bias in interventional studies ( Section 8.5, Table 8.5a ). 2

Many recent studies also analyze and suggest more efficient and reliable ways to assess the quality of quantitative, qualitative, and mixed methods studies.   See supplemental resources .

Critical appraisal worksheets may be useful  for a small number of studies. Some examples of these can be found on the Oxford Centre for Evidence-Based Medicine's (CEBM) website , and Duke's EBP research guide . Note whether you decide to modify these worksheets in order to save time; this may create some bias in your conclusions.

As a result of your choices in Step 2 , what biases will be introduced into your protocol? Are these biases acceptable given your time constraints?

Plan your search.

• Consult with a health sciences librarian . Some studies have shown that librarian involvement can improve the quality of reported systematic review and meta-analysis search strategies. 9,10
• Determine the best method for documenting your search (e.g. spreadsheet, etc.). 
• Select a citation management tool to use. VCU librarians can provide instruction and troubleshooting for Mendeley and Zotero, which are free to the VCU community.

Execute your search and store your citations.

Screen search results based on the criteria defined in Step 2 .

A table or worksheet is often used to keep track of the screening and review process. Sample screening worksheets: 1 , 2 , 3 .

Apply appraisal tool/rubric selected in Step 2 to identify high quality studies that  will be included in your evidence synthesis. The simplest way to track the final quality judgment will vary by tool, e.g.  1 , 2 .

Evidence summary tables are used to track important characteristics of appraised studies, including the reference, study design, sample size, and quality score. Examples of tables used to present the studies included in a review differ by the aspects listed above as well as other, e.g. 1 , 2 , 3 .  Consider creating your own review matrix (sample Excel file)   to take notes on papers that will be included in your study.

A narrative synthesis of studies that made it through the screening and quality appraisal phases is a simple, efficient way to set the stage for your own work. At a minimum, the synthesis should include:

• Study problem / purpose
• Why is the research important?
• Has it been done before?
• How will the study benefit patients, increase knowledge, or influence policy?
• What methods are most commonly used in previous studies?
• What are the most common outcomes analyzed?
• Is there a significant patient population that is not well - studied?
• What limitations were present in the existing body of research?
• What sources of bias could have been introduced in your review of literature?
• Last Updated: Nov 9, 2023 2:15 PM
• URL: https://guides.library.vcu.edu/rapidreview

Key concepts in rapid reviews: an overview

Affiliations.

• 1 Evidence Synthesis Ireland & Cochrane Ireland, University of Galway, Galway, Ireland; School of Nursing and Midwifery, University of Galway, Galway, Ireland; HRB-Trials Methodology Research Network, University of Galway, Galway, Ireland. Electronic address: [email protected].
• 2 School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
• 3 Department for Evidence-based Medicine and Evaluation & Cochrane Austria, University for Continuing Education Krems, Krems, Austria; Center for Public Health Methods, RTI International, Research Triangle Park, NC, USA.
• 4 Department for Evidence-based Medicine and Evaluation & Cochrane Austria, University for Continuing Education Krems, Krems, Austria.
• 5 Evidence Synthesis Ireland & Cochrane Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland.
• 6 School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Global Health & Guidelines Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
• PMID: 39245414
• DOI: 10.1016/j.jclinepi.2024.111518

Background and objective: Rapid reviews have gained popularity as a pragmatic approach to synthesize evidence in a timely manner to inform decision-making in healthcare. This article provides an overview of the key concepts and methodological considerations in conducting rapid reviews, drawing from a series of recently published guidance papers by the Cochrane Rapid Reviews Methods Group.

Study design and setting: We discuss the definition, characteristics, and potential applications of rapid reviews and the trade-offs between speed and rigor. We present a practical example of a rapid review and highlight the methodological considerations outlined in the updated Cochrane guidance, including recommendations for literature searching, study selection, data extraction, risk of bias assessment, synthesis, and assessing the certainty of evidence.

Results: Rapid reviews can be a valuable tool for evidence-based decision-making, but it is essential to understand their limitations and adhere to methodological standards to ensure their validity and reliability.

Conclusion: As the demand for rapid evidence synthesis continues to grow, further research is needed to refine and standardize the methods and reporting of rapid reviews.

Plain language summary: Rapid reviews are a type of research method designed to quickly gather and summarize evidence to support decision-making in healthcare. They are particularly useful when timely information is needed, such as during a public health emergency. This article explains the key aspects of how rapid reviews are conducted, based on the latest guidance from experts. Rapid reviews involve several steps, including searching for relevant studies, selecting which studies to include, and carefully examining the quality of the evidence. Although rapid reviews are faster to complete than full systematic reviews, they still follow rigorous processes to ensure that the findings are reliable. This article also provides an example of a rapid review in action, demonstrating how these reviews can be applied in real-world situations. While rapid reviews are a powerful tool for making quick, evidence-based decisions, it is important to be aware of their limitations. Researchers must follow established methods to make sure the results are as accurate and useful as possible. As more people use rapid reviews, ongoing research is needed to improve and standardize how they are done.

Keywords: Evidence synthesis; GRADE approach; Healthcare decision-making; Methodological trade-offs; Rapid reviews; Systematic review.

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

• En español – ExME
• Em português – EME

What are ‘rapid reviews’ and why do we need them?

Posted on 20th July 2022 by Zain Douba

Rapid reviews are a form of knowledge synthesis that follow the systematic review process, but components of the process are simplified or omitted to produce information in a timely manner (Khangura, 2012) .

Palmatier et al. describe review papers as:

Critical evaluations of material that has already been published regardless of the type of study design.

Progressively, reviews scan the literature to answer a research question briefly.

Types of review articles

There are more than 14 types of ‘r eview articles’; here are some of the main types:

• Critical review
• Literature (Narrative) review
• Mapping review
• Meta-analysis
• Mixed studies review
• Rapid review
• Scoping review
• Systematic review
• Systematized review
• Umbrella review

So, what is a rapid review?

A rapid review is a form of knowledge synthesis that accelerates the process of conducting a traditional systematic review through streamlining or omitting specific methods to produce evidence for stakeholders in a resource-efficient manner.

The timeframe of the review depends on resource availability, the quantity and quality of the literature, and the expertise or experience of reviewers.

As a guide, the stages and timeframe of the rapid review are:

• Timeframe: ≤ 5 weeks
• Question: Narrow question (may use the PICO framework – YouTube video )
• Searches: Sources are limited due to time constraints of searching. Must still be transparent and reproducible
• Selection: Based on inclusion/exclusion criteria
• Appraisal: Critical and rigorous but time-limited
• Synthesis: Descriptive summary or categorization of data, may still be quantitative

The main role of the rapid review

Policy-makers require valid and reliable evidence to support time-sensitive decisions, and will need to assess the quality and efficiency of that evidence.

Systematic reviews and other types of evidence syntheses are increasingly being used to inform, and lead, health policy decision-making. However, the time and cost to produce a systematic review are often barriers to its use in decision-making.

Rapid reviews are a timely and affordable approach that can provide actionable and relevant evidence to strengthen health policy and systems.

What are the key advantages of rapid reviews?

The rapid review can benefit the scientific community in many ways:

• Provide an incorporated, synthesized overview of the currently available evidence
• Evaluate existing methodological approaches and unique insights
• Describe research understandings, existing gaps, and future research directions

In other words, the methodology used in a rapid review aims to limit some secondary steps compared to the systematic review, in order to produce focused research. This includes carefully focusing on the question, using broader or less sophisticated search strategies, conducting a review of reviews, restricting the amount of grey literature, extracting only key variables, and performing only ‘simple’ quality appraisal. Thus, not every review paper can offer all of these benefits, but this list represents their key contributions.

Conclusions

Clinicians, stakeholders, consumers, and policy-makers usually tend to digest and produce health-related decisions in a timely and resource-efficient manner. Concurrently, researchers tend to conduct ‘summarized evidence’ to respond to the need for the most recent and valid evidence.

Many readers tend to access the most summarized articles that come under the categories of improving patient care, health systems, decision-making, and international policies.

And now, can you tell me why and how you are planning to conduct a rapid review?

References and resources

A typology of reviews: an analysis of 14 review types and associated methodologies

Evidence summaries: the evolution of a rapid review approach

Review articles: purpose, process, and structure

Systematic Reviews & Other Review Types

Rapid Review Protocol

Cochrane Rapid Reviews: Interim Guidance from the Cochrane Rapid Reviews Methods Group

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Updated recommendations for the Cochrane rapid review methods guidance for rapid reviews of effectiveness

• Related content
• Peer review
• Marialena Trivella , research associate, senior methodologist, and assistant professor 4 5 6 ,
• Gerald Gartlehner , professor and senior health research analyst 4 7 ,
• Barbara Nussbaumer-Streit , co-director 4 ,
• Declan Devane , professor 8 ,
• Chris Kamel , director 9 ,
• Ursula Griebler , senior research associate 4 ,
• Valerie J King , professor 10
• on behalf of the Cochrane Rapid Reviews Methods Group
• 1 School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada
• 2 Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, ON, Canada
• 3 Canadian Association of Radiologists, Ottawa, ON, Canada
• 4 Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
• 5 Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK
• 6 Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
• 7 Research Triangle Institute (RTI) International, Research Triangle Park, NC, USA
• 8 Cochrane Ireland and Evidence Synthesis Ireland, School of Nursing and Midwifery, University of Galway, Galway, Ireland
• 9 Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, ON, Canada
• 10 Center for Evidence-based Policy, Department of Family Medicine, Oregon Health and Science University (OHSU), Portland, OR, USA
• Correspondence to: C Garritty chantelle.garritty{at}uottawa.ca (or @cgarritty on Twitter)
• Accepted 2 January 2023

This article provides updated guidance on methods for conducting rapid reviews of effectiveness, targeted at Cochrane and other stakeholders interested in the methodology of rapid reviews. The guidance, developed by the Cochrane Rapid Reviews Methods Group, builds upon previous interim guidance, and incorporates changes based on an evaluation of its application, a scope of the literature on rapid review methodology, and input from a diverse group of experts in rapid review methods. The guidance consists of 24 specific recommendations supporting the conduct of rapid reviews, applicable both within and outside Cochrane. It underscores the importance of considering the appropriateness of undertaking rapid reviews and advocates for a tailored, iterative approach to each review. Key defining features of rapid reviews, such as restricted methods, how the dimension of timelines factors into rapid reviews, and the involvement of knowledge users (eg, patient and public partners, healthcare providers, policy makers), are outlined. The paper presents a definition of a Cochrane rapid review and additional considerations for rapid reviews of effectiveness to enhance the efficiency of the review process. In conclusion, the Cochrane Rapid Review Methods Group’s updated guidance, complemented by examples, seeks to guide methodological decisions in the design and conduct of rapid reviews, facilitating timely decision making in healthcare.

Summary points

This article updates the Cochrane rapid review methods guidance published in 2020 to support rapid reviews of effectiveness in the context of urgent and high priority health questions

The updated guidance incorporates new knowledge and feedback from users of the interim guidance, with input from a broader group of methodologists specialising in rapid reviews, and it is both evidence informed and user informed and widely applicable to anyone conducting a rapid review

The update clarifies key concepts underpinning rapid reviews, provides a refined list of 24 recommendations, offers supporting examples, and provides best practice considerations and practical tips for teams to increase efficiencies

The Cochrane Rapid Reviews Methods Group will continue to promote research, monitor published literature, and update recommendations to facilitate timely, evidence based decision making in healthcare

Introduction

In recent years, the Cochrane Collaboration, a global leader in producing high quality systematic reviews and methodological guidance, has taken steps to support rapid reviews. In 2020, the Cochrane Rapid Review Methods Group published interim guidance on the conduct of rapid reviews of effectiveness produced within Cochrane and beyond. 1 Guidance was developed to focus on rapid reviews of health interventions to address urgent and high priority questions. The original guidance was informed by a suite of research, including a scoping review of the underlying evidence, 2 a proposed definition of a rapid review, 3 primary meta-epidemiological studies, 4 5 and a survey of Cochrane community members who prioritised the appropriateness of rapid review methods across stages during the conduct of reviews. 1 The original guidance offered 26 recommendations, with accompanying rationales on the steps and considerations for accelerating each part of the review process. Completion of the guidance coincided with the onset of the covid-19 pandemic, which was the catalyst for the increased number of Cochrane and non-Cochrane rapid reviews conducted and published since 2020. 6 The pandemic showed the importance of expedited systematically produced evidence synthesis to address many clinical, public health, and health policy and systems related questions.

In this article, we present an update on the interim Cochrane rapid review methods guidance, integrating new knowledge on the conduct of the reviews and feedback from users of the interim guidance. We clarify key concepts underpinning rapid reviews, include a refined list of recommendations, and provide some accompanying examples, supporting information, and links to additional resources to guide methods for those interested in the methodology of rapid reviews. The decision to update the interim guidance on Cochrane rapid review methods at this juncture was driven by several critical factors. The original guidance was expedited for release during the onset of the covid-19 pandemic, ensuring timely access for Cochrane’s network of reviewers and the broader research community grappling with urgent needs for evidence synthesis. Consequently, refinement of the recommendations was temporarily halted. As stated in our interim guidance, the increase in published rapid reviews, combined with our commitment to ongoing quality improvement efforts, underscored the need to align the guidance now with the evolving landscape of rapid review methodology after the pandemic. In addition, insights gleaned from an evaluation assessing the guidance’s real world use have pinpointed areas requiring enhancement, particularly in terms of user friendliness and practicality for authors of rapid reviews with varying levels of experience. 7

This update of the Cochrane rapid review methods guidance builds upon previously published interim guidance. 1 We have also integrated findings from a formal evaluation conducted to assess authors’ adherence to and understanding of the interim Cochrane guidance and the guidance’s comprehensibility, usability, and usefulness. A complete description of the evaluation is available elsewhere. 7 This evaluation included the text analysis of 128 rapid reviews (17 Cochrane and 111 non-Cochrane) and 20 in-depth qualitative interviews. Main findings suggested that many authors did not follow certain recommendations, such as the stepwise approach to study inclusion or peer review of search strategies. However, some recommendations, such as dual independent screening of abstracts or full texts, were exceeded. Common reasons for not adhering to the guidance included time constraints, unclear recommended approaches, or inapplicability to specific rapid reviews. Overall, the guidance was considered user friendly, but it was perceived as challenging to apply without experience of conducting systematic reviews. On this basis, we identified the need to change the wording of some recommendations and to clarify others, further keeping in mind that the guidance might be used by investigators with varied experience of systematic review and rapid review methods. 7 As such, this updated guidance clarifies some defining features of rapid reviews and additional aspects to consider for Cochrane rapid reviews.

We also scanned the literature for publications related to rapid review methodology published since the initial scoping review that underpinned our interim guidance in 2020. 2 To identify potentially relevant studies, we used the option for similar articles in PubMed for every article included in the initial scoping review. We also searched PubMed using a general keyword search based on our original scoping review search strategy. We limited searches from February 2019 (the previous search) to August 2022. A total of 841 citations were then screened and 87 articles assessed for relevancy in accordance with an initial scoping review of rapid review methods 2 (see subsection w1 in the supplementary file for list of studies). Although none met the original eligibility criteria, five studies provided further insights to the search recommendations. 8 9 10 11 12

Furthermore, we assembled a broader collaborative of rapid review methodologists beyond the coauthor group, who provided specific input on proposed modifications to the guidance. Led by the Cochrane Rapid Review Methods Group, this group of experts, including a patient and public partner, has produced a multipart series to further guide methods decisions in each step of the process for rapid reviews. 13 14 15 16 The series expands on and explains in further detail what this updated methods guidance recommends.

Cochrane methods guidance considerations

Cochrane defines a systematic review as using systematic and explicit methods to identify, select, critically appraise, extract, and analyse data from all relevant research. 17 Rapid reviews also use systematic and explicit methods to appraise, extract, and analyse data. By comparison, however, specific components of the systematic review process are either restricted or omitted or the scope is narrowed for rapid reviews, to provide an evidence synthesis product more quickly. Therefore, as rapid reviews might not include all relevant studies, they may be less comprehensive. As a result, the appropriateness of undertaking a rapid review needs to be considered carefully, with a strong justification provided for using this approach instead of a systematic review, including the rationale for using restricted methods. 18 General distinctions between systematic reviews and rapid reviews have been published previously. 19 20

In updating the interim guidance, it is also important to emphasise that Cochrane rapid reviews should be driven by the need for timely evidence for decision making purposes, including addressing urgent and emergent health issues and questions deemed high priority. Additionally, when conducting a rapid review, multiple methodological paths can be taken, and no “one size fits all” approaches can be applied. Rapid reviews are tailored and therefore can vary in scope and methodology depending on time and resources available, restricted methods used (or a combination of restrictions), and the types and levels of evidence included. Although this guidance is intended as best practice advice to determine the methodological way forward when conducting a Cochrane rapid review, not every restricted method that is recommended needs to be implemented. Teams may use stricter methods, if time and resources allow, and still call it a rapid review, as discussed below.

For this update we have clarified key defining features of rapid reviews relative to systematic reviews:

Restricted methods —To accelerate the review process, it is typical for rapid reviews to introduce methodological restrictions (shortcuts or abbreviated methods). Therefore, the reviews should be well reported, highlighting the restricted methods taken to accelerate the review, the potential biases these methods may have introduced, and other limitations of the evidence base.

Dimension of time —Despite the term “rapid” being used for these reviews, time is not the sole defining feature—although rapid reviews should be conducted in a short timeline. Timelines across the reviews vary, however, depending on several factors, including the complexity of the topic or the urgency of the decision making to meet timelines, which are often short out of necessity. Importantly, the notion that rapid reviews are simply systematic reviews done faster is misleading. A rapidly conducted systematic review would still be a systematic review if authors followed stringent systematic review methodology, such as methods proposed by Cochrane. 17 Consistent with our interim guidance, we continue to endorse that Cochrane rapid reviews should take no longer than six months.

Knowledge user involvement —As decision makers typically commission rapid reviews to address specific and pressing health questions, it is common for them to be involved in the process, given the urgent nature of these inquiries. However, other important knowledge users (eg, patient and public partners, healthcare providers, and policy makers) may also be involved in shaping the rapid review. In collaboration with funders and other knowledge users, the scope of the review should be narrowed down to answer a focused question.

Cochrane rapid reviews

We recommend the following definition for a Cochrane rapid review: “A rapid review is a type of evidence synthesis that brings together and summarises information from different research studies to produce evidence for people such as the public, healthcare providers, researchers, policy makers, and funders in a systematic, resource efficient manner. This is done by speeding up the ways we plan, do, and/or share the results of conventional structured (systematic) reviews, by simplifying or omitting a variety of methods that should be clearly defined by the authors.” This definition builds upon the original definition endorsed in the interim guidance, 16 and it was modified following the input of patient and public partners as part of a recent collaborative Priority Setting Partnership on rapid reviews. 3

Additional aspects also need to be considered when applying this guidance:

Guidance for rapid reviews of effectiveness —Importantly, this guidance was developed within the context of Cochrane and focuses on rapid reviews concerning the effectiveness of health interventions, albeit it may be used for non-Cochrane reviews of effectiveness. This guidance has not yet been adapted beyond interventions of effectiveness to other question types relevant to rapid reviews (eg, rapid reviews of diagnostic test accuracy or screening, or rapid qualitative evidence synthesis) since specific review question types may pose unique methodological challenges. 21 Examples of other review question types and methodological considerations for rapid reviews can be found at https://methods.cochrane.org/rapidreviews/rr-methods-guidance/additional-methodological-considerations .

Experience of systematic reviews —Rapid review teams should include expertise from information specialists and have access to clinical experts and individuals with expert knowledge of systematic review methods, ideally available throughout the rapid review process to guide and advise on the strengths and limitations of abbreviated methods to minimise compromising validity.

Access to electronic databases and software —Rapid review teams must have adequate resources before embarking on the review. Required resources include access to electronic databases most relevant to the topic of rapid reviews (eg, Medline, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, PsycInfo), reference management software (eg, Endnote, Zotero, RefWorks), screening software (eg, Rayyan, Covidence, DistillerSR), a virtual meeting platform (eg, Google meet, Zoom, MS Teams), and possibly other messaging applications used to facilitate timely communications and project management across the rapid review team (eg, Slack). We recommend that teams use live document platforms, as these enable real time collaboration, version control, and efficient information sharing, ultimately streamlining the review process. Some of these resources are freely available, whereas others require access through a library or academic institution or a paid user licence.

Cochrane rapid review recommendations

The Cochrane Rapid Review Methods Group has issued an updated list of 24 recommendations for Cochrane rapid reviews as outlined in table 1 , with rationales and examples to support the recommendations provided in subsection w2 of the supplementary file. Rapid review teams may apply all or some of the methodological restrictions proposed in the recommendations, depending on the topic, timeframe, and resources.

Updated guidance on methods used in Cochrane rapid reviews of effectiveness

• View inline

Topic refinement—setting the research question

Recommendation 1: Involve knowledge users to set and refine the review question, eligibility criteria, and outcomes of interest, with consultation at various stages of the review

Knowledge users are individuals or groups responsible for, or affected by, health and healthcare related decisions that rapid reviews can inform. 22 23 The term knowledge user includes but is not limited to healthcare providers and their professional associations, policy makers, patients, caregivers, patient groups, government agencies, and the public. 24 By their very nature, rapid reviews often necessitate close and intensive collaboration between researchers and decision makers, including the organisations that commissioned them. 25 However, the involvement of key knowledge users (eg, patient and public partners, healthcare providers, and policy makers) is often limited, omitted, or not reported. 26 Although meaningful involvement requires time, resources, and advanced planning given the shortened timelines of rapid reviews, involving key knowledge users when possible can enhance the relevance and applicability of the review and should be encouraged. 27 28 The STARR (SelecTing Approaches for Rapid Reviews) tool aids authors in planning approaches to rapid reviews and obtaining structured input from users through targeted questions. 29 A recent publication provides further insight on ways to involve knowledge users in the co-development of rapid reviews (eg, planning, performance, and knowledge translation of the reviews). 13 Authors of Cochrane rapid reviews should be aware of Cochrane’s new framework for consumer (patient, carer, and public) engagement and involvement 30 and should leverage the Cochrane Consumer Network to identify potential patients, carers, and the public as knowledge users. 31

Recommendation 2: Develop a protocol that includes the review questions, description of the population, interventions, comparators, outcomes, and methods of conducting the review

As you would for a systematic review, it is important to develop a protocol for the rapid review that supports the principles of transparency and reproducibility. Protocols should include the review question or questions, using a question framework such as PICOs (population-intervention-comparator-outcomes), and detail the eligibility criteria and methods that will be used for searches, study selection, data extraction, risk of bias, and synthesis. The authors of Cochrane rapid reviews must submit a completed protocol to the Cochrane central editorial service ( [email protected] ), which will undergo editorial and methodological checks. Cochrane has a streamlined workflow and protocol template to accommodate rapid reviews across priority topics (see https://covidreviews.cochrane.org/resources ) . Non-Cochrane rapid reviews may use this template as a guide. If this template is not used, protocols should be reported to the extent possible following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). 32 If the time for peer review is limited, protocols should, at a minimum, be reviewed internally for consistency and accuracy. For transparency, authors should ensure public availability of their protocol through open access platforms (eg, PROSPERO, Open Science Framework).

Recommendation 3: Clearly define the eligibility criteria, including any restrictions or limits

To ensure rapid reviews are manageable and timely, various restrictions can be applied to eligibility criteria (eg, PICOs, timing, settings, date) (see recommendations 3.1 to 3.6). Such restrictions must be considered through discussions with the rapid review team and knowledge users.

Recommendation 3.1: Limit the number of interventions and comparators —So the review is focused and manageable, the number of interventions and comparators should be limited. Any such restrictions should not impact the decision making ability of knowledge users.

Recommendation 3.2: Limit the number of outcomes, focusing on those most important for decision making —When developing the protocol, focus on outcomes that are relevant for knowledge users and important for decision making. The recommendation is to rate outcomes by importance, with seven as a maximum 33 (although fewer may be better for a rapid review, depending on available time and resources). The list of outcomes may be restricted at any point throughout the conduct of the rapid review in consultation with knowledge users. Ideally, a core set of outcome measures would be available to inform decisions on outcome selection (eg, from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative 34 ). Outcomes will depend on the needs of knowledge users and should include outcomes for both potential benefits and potential harms.

Recommendation 3.3: Consider restricting the search date of the evidence base, with clinical or methodological justification provided —Although setting a date restriction is a pragmatic decision in some cases, this needs to be carefully considered for each topic. When conducting a rapid review, authors should consider the trade-offs (ie, the potential for less accuracy with the loss of studies versus workload) by different limits of a search date. 11 35 To make the right decision, authors should also assess each case individually because of variation in topics. When it is deemed important to avoid date restrictions, other approaches described in this guidance may be needed to deal with the potentially high number of search results. Regardless, rapid review teams should provide an appropriate justification if instituting date restrictions (see subsection w2 in the supplementary file). Besides, close communication with information specialists and clinical experts will help to set informed date limits. Other knowledge users may also provide insight on whether date limits are appropriate for each topic.

Recommendation 3.4: Limit the setting, with clinical or methodological justification provided —Limitations on the setting may be related to geographical areas or regions (eg, studies in the UK, low income and middle income countries, rural settings) and where the study is conducted, such as in the community or in a hospital. Any restrictions in the setting should be justified and relevant (see subsection w2 in the supplementary file) and should not impact the decision making ability of knowledge users.

Recommendation 3.5: Limit the publication language to English at study selection, with other languages added when relevant —Language restrictions during the initial search process are discouraged; we advise applying these restrictions during the study selection phase. Research suggests that excluding non-English publications from systematic reviews on clinical interventions has a minimal effect on overall conclusions and can be a viable methodological shortcut for rapid reviews. 4 We do not, however, recommend restricting to English only publications if previous knowledge suggests that studies relevant to the chosen rapid review topic may be published in languages other than English. Suppose, for example, rapid reviews are related to complementary and alternative medicine treatments. In that case, relevant studies in languages other than English would be expected, and studies published in these languages should be included in the rapid review. Ensure that any language limits are justified and clearly explained (see subsection w2 in the supplementary file).

Recommendation 3.6: Prioritise the inclusion of high quality study designs relevant to the review question or objective —Determine what levels of evidence to include and ensure the decision for this approach is well explained (see subsection w2 in the supplementary file). For example, if one or more well conducted systematic reviews has been done that address the question of the rapid review, including and updating these systematic reviews may be sufficient. Randomised controlled trials should be considered for effectiveness questions if no well conducted systematic reviews exist or do not address the PICOs sufficiently. In the absence of well conducted randomised controlled trials for effectiveness questions, or if time permits, or both, non-randomised studies may be considered. This implies that researchers should understand study designs and their characteristics, relationship to the review question or objective, and potential for bias. Importantly, systematic reviews and randomised controlled trials may not be available for new healthcare interventions—for example, no randomised controlled trials were available on covid-19 during the early era of the pandemic but emerged as the pandemic evolved. 36

Recommendation 4: Involve an information specialist to develop the search strategy, and consider search methods, resources, and search limits

Planning a search is integral to the overall preparation of a rapid review and should form part of protocol development. At minimum an information specialist such as a librarian should be consulted to select information sources (eg, bibliographic databases, type of supplementary searches) and provide feedback on the primary search strategy. 37 Information specialists can assist in selecting appropriate search methods and resources, defining search limits, designing and executing search strategies, and reporting the search methods. A preliminary or scoping search should be performed during the topic refinement stage and may help inform eligibility criteria. If the rapid review is being done by updating an existing systematic review, information specialists may use the original search strategy and adapt as necessary. Overall, the search process for a rapid review follows the same steps as for a systematic review; therefore, rapid review teams must be familiar with the general standards of systematic searching and reporting of searches. 38

Recommendation 5: Select a small number (but at least two) bibliographic databases that are likely to contain relevant literature

Rapid review teams should prioritise the most relevant information sources for the topic, the type of evidence required, and access to sources. We recommend a conventional approach of selecting at least two electronic bibliographic databases, dependent on the study type and topic most likely to retrieve relevant literature based on recent evidence. 12 35 39 In addition to electronic bibliographic databases, grey literature sources and targeted supplementary search methods may be used (see recommendation 7).

For rapid reviews focused on randomised controlled trials only, use a combination of two of the following databases (if you have access): Medline, CENTRAL, and Embase. 39

Additional considerations:

▪ For Cochrane rapid reviews of health interventions, where search strategies are always designed by information specialists and peer reviewed using the Peer Review of Electronic Search Strategies (PRESS) statement 37 (see recommendation 6), we recommend using CENTRAL as the primary database. This is a highly concentrated source of reports of randomised controlled trials and quasi-randomised controlled trials. In many regions, CENTRAL is free through the Cochrane Library. 40 In addition, it is accessible to Cochrane members through the Cochrane Register of Studies Online ( https://crso.cochrane.org/ ). 41 Additional searches of Medline, such as through PubMed, and possibly Embase (if access is available) may be limited to the previous two months to capture the most recently published studies, as CENTRAL is currently only updated once a month. 9 39 42

▪ If CENTRAL and Embase are not available, searching Medline combined with an appropriate supplementary search (eg, a study register such as ClinicalTrials.gov, using the PubMed similar articles feature) can be considered, but this strategy might not be appropriate for all topics. 9 14

For other rapid reviews that include non-randomised studies, database selection should be carefully considered depending on available time and resources. In many cases, Medline will be the most relevant database, but this is not always the case. 10 43 Searching specialised databases such as CINAHL, PsycInfo, and the Education Resources Information Center (ERIC), may be necessary for specialised review topics (eg, CINAHL for rapid reviews related to nursing care, PsycInfo for rapid reviews related to mental health, or ERIC for rapid reviews related to educational interventions); see subsection w2 in the supplementary file.

Recommendation 6: Use the PRESS checklist to peer review the primary search strategy

The primary search strategy should be peer reviewed using the PRESS checklist when possible. 37 If the use of PRESS is not possible, at a minimum the search strategies should be double checked for typographical or spelling errors, missed keywords, and correct use of Boolean operators (AND, OR, NOT). Evidence suggests that the absence of peer review of the search strategy often results in many missed studies, and unless captured in accompanying supplementary searches, these studies would not appear in the published rapid review. 44

Recommendation 7: Assess the need for grey literature and supplemental searching. Justify the sources to be searched

For rapid reviews, we recommend limiting grey literature and supplemental searches. For some topics, however, a search of grey literature may be more important than a search of conventional databases. If warranted, consider limiting supplemental searches to clinical trial registries and review of reference lists in included studies or similar articles searches to identify potentially relevant studies (see subsection w2 in the supplementary file file). More in-depth best practice suggestions on searching for rapid reviews are available. 14 45

Study selection—title and abstract and full text screening

Recommendation 8: Employ piloting exercises at abstract and full text screening levels to allow team members to test the study selection process on a selected sample of records to ensure a consistent approach to screening

Before the start of screening, a pilot exercise should be conducted using a purposive selection of records (eg, 50-100 records that reflect the complexity of the topic) assessed by the entire team of screeners to test and revise the screening forms and adapt the eligibility criteria, if necessary. This pilot exercise also allows a discussion of unclear abstracts and identification of potential difficulties in the study selection process. To ensure a consistent approach to screening is used across the entire team, all screeners should use a title and abstract screening form followed by a full text screening form. These forms should include details on the eligibility criteria with examples and can be phrased as screening questions. The screening forms should be adapted after discussions among the team, if necessary.

Recommendation 9: Conduct dual and independent screening of a proportion of records, assess reviewer agreement, and proceed with single screening if agreement is good

Generally, we recommend that two reviewers should screen at least 20% of the records, check the level of agreement, and discuss any discrepancies. Teams can proceed with single screening if agreement is high (eg, κ is ≥0.8). 46 47 If agreement is low, the screening team should proceed with dual reviewer screening until a better agreement has been achieved. The suggestion of 20% is based on our experience and is therefore not evidence based. The proportion may differ depending on the number of records to be screened, available resources, complexity of the review topic, and reviewers’ experience. We recommend the same approach for full text screening (see subsection w2 in the supplementary file). If resources allow, one person could check all excluded full texts to ensure no relevant study was unintentionally excluded. Further details on this process are available elsewhere. 15

If a search yields a small number of records, such as a few hundred citations, consider dual, independent screening, if it is feasible. Although screening with only one reviewer for each record may be a practical solution for certain rapid reviews, we do not recommend this for Cochrane rapid reviews. Findings from two studies indicate that single screening of the titles and abstracts is not equivalent to dual screening, as more studies are missed. 5 48 Nonetheless, forthcoming advances in automation (eg, active machine learning) 49 50 and crowdsourcing 8 51 have the potential to reduce screening time when conducting rapid reviews.

Recommendation 10: Limit data extraction to only the most important data fields relevant to address the review question

No minimum set of data extraction items exists for study characteristics and outcome data. For a rapid review, however, extraction should be limited to only the most important data fields. For example, outcome data should only be extracted for those outcomes deemed as most relevant for decision making (see recommendation 3.2).

Recommendation 11: For data extraction, employ a piloting exercise to ensure all team members perform it consistently and correctly

We recommend using a form for data extraction (eg, a table or spreadsheet) and involving all reviewers in a data extraction pilot test using the same studies (at least two). This should help to identify misunderstandings early on and should reduce disagreements during the data verification step (see recommendation 12). The form should also help in deciding which study characteristics and outcome data should be extracted using concise descriptions of participant, intervention, comparator characteristics, and outcomes assessed (see recommendation 10).

Recommendation 12: Have one person extract the data, and for critical data that can affect the results or conclusions, have a second person verify the data for accuracy and completeness

We recommend that one person should extract the data for rapid reviews, with a second person verifying the key data (eg, definitions of outcomes, outcome data) for completeness and correctness to ensure integrity of the review. The second reviewer will also need to check the full texts. Any disagreements should be resolved through discussion and consensus between reviewers, involving a third reviewer if agreement cannot be reached (see subsection w2 in the supplementary file). If time and resources allow, a second person should verify the remaining data, such as characteristics of the study.

Recommendation 13: When available, extract data directly from existing systematic reviews rather than from primary studies

If good quality systematic reviews are included in the rapid review, consider extracting data directly from the systematic review. According to a case study, this approach saved time and did not alter the review results. 52 However, extracting data directly from a systematic review requires good reporting of the data included in the review. As stated in recommendation 11, a second person should check the critical data extracted from the systematic review for completeness and correctness (see subsection w2 of the supplementary file).

Risk of bias assessment

We discourage omitting the risk of bias assessment entirely, as it informs the interpretation of the results.

Recommendation 14: Use validated and study design specific tools to assess the risk of bias of the included studies

To effectively manage the risk of bias assessments, it is important to use validated assessment tools specific to the study design(s) included in the rapid review. For example, for Cochrane rapid reviews, versions 1 and 2 of the Cochrane risk of bias tool for randomised trials (RoB 1 and RoB 2, respectively) 53 54 should be used for randomised controlled trials. Permitting both outcome level risk of bias (RoB 2) and domain level risk of bias (RoB 1) assessments in rapid reviews is suggested for practical purposes. RoB 1 assessments are generally quicker and require fewer resources than RoB 2 assessments at the outcome level. However, different rapid reviews may require different levels of detail and granularity in the risk of bias assessment that may depend on the specific characteristics of the review, such as the complexity of the interventions, type of outcomes, and available data. Allowing either approach ensures an efficient use of available resources while maintaining the quality of the review.

For non-randomised interventional studies, the Risk Of Bias In Non-Randomised Studies-of Interventions (ROBINS-I) 55 should be used. AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews) 56 or ROBIS 57 may be used to assess risk of bias in systematic reviews.

Recommendation 15: Focus the risk of bias assessment at least on the most important outcomes

When using risk of bias tools with questions that rate the risk at an outcome level (not study level), such as RoB 2, limit the risk of bias ratings to the outcomes important for decision making (see recommendation 3.2).

Recommendation 16: Have one person perform the risk of bias assessment, with a second person verifying the judgements

The recommended approach to risk of bias assessment involves one reviewer performing the assessment, and another reviewer verifying the judgements. If only a small number of studies are eligible for inclusion, consider dual, independent risk of bias assessments for key outcomes, if feasible. In preparation, it may be helpful for all involved in risk of bias assessment to assess a small number of studies, such as two or three, concurrently and discuss the corresponding judgements so that any discrepancies may be identified and resolved (see subsection w2 in the supplementary file).

Teams involved in rapid reviews need to develop an appropriate analysis plan, which should be included in the protocol (see recommendation 2).

Recommendation 17: Provide a descriptive summary of the included studies

Providing a descriptive summary of the included studies at the outset of the synthesis stage helps to confirm if the studies are similar and reliable enough to synthesise and if it is possible to pool results. “Similar” studies means that they have similar PICOs, and, ideally, study designs.

Recommendation 18: Perform a synthesis of the findings

For rapid reviews that only include primary studies, reviewers need to decide how to group and tabulate data based on the review question, the type of data included, and what was planned for in the protocol, to the extent possible. Beyond a simple descriptive summary, a narrative interpretation of the evidence from multiple studies should be conducted for all rapid reviews. Reviewers should organise the synthesis around the elements of the PICO question framework, with findings grouped by key questions, comparisons, interventions, and outcomes. If a meta-analysis is possible, a descriptive summary of the body of evidence contributing to the meta-analysis is needed to interpret the collective evidence fully. Synthesis without meta-analysis (SWiM) reporting guidelines should be considered to promote transparency of narrative reporting of evidence synthesis. 58

Recommendation 19: Consider a meta-analysis if appropriate and resources permit

If data are sufficient to consider a meta-analysis, the standards for a systematic review equally apply to a rapid review; meta-analysis will depend on the type of data and information provided in the individual studies. It is important to involve a statistician familiar with systematic reviews and meta-analyses. The depth and details of analysis will vary depending on the volume and type of included studies.

Recommendation 20: Consider how to synthesise evidence when including one systematic review or more

When including systematic reviews in a rapid review, synthesis may involve adding primary studies to an existing meta-analysis or narrative synthesis from the systematic review. If more than one systematic review is included, the overlap of primary studies must be identified. A formal study of overlap (eg, corrected covered area 59 ) does not need to be undertaken for a rapid review. Instead, a cursory examination of overlap may be presented in tabular form to identify all included systematic reviews with the relevant primary studies to explore why reviews agree or disagree on important findings. A publication on synthesis for rapid reviews will be forthcoming as part of the Rapid Reviews Methods Series led by the Cochrane Rapid Review Methods Group.

Certainty of the evidence

Recommendation 21: Use the GRADE approach to assess certainty of evidence if time and resources allow

Cochrane Reviews incorporate the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for rating the certainty of evidence 60 as it is the established benchmark for use in guideline development. Several examples have been published where the GRADE approach has been used for rapid reviews. 61 62 63 We therefore recommend fully implementing GRADE for both Cochrane and non-Cochrane rapid reviews if time and resources allow. We also recommend using GRADEpro, an open access software tool for rating certainty of evidence in evidence syntheses to apply GRADE. 64 Reviewers should always present results in a summary of findings table when rating certainty of evidence and use explanatory footnotes to outline reasons for uprating or downrating judgements.

Recommendation 22: Limit the certainty of evidence ratings to the main intervention and comparator and focus on critical outcomes

If time and other resources do not permit the full implementation of GRADE, we recommend that reviewers limit certainty of evidence ratings to the main intervention and comparator and focus on critical outcomes of benefits and harms. See recommendation 3.2 on the selection of critical outcomes. 33 60 The approach chosen should, in any case, be transparent, and any limitations acknowledged.

Recommendation 23: Have one person complete the GRADE assessment, with a second person to verify the assessment

To accelerate GRADE application, we recommend a single reviewer rating, and verification of all decisions (and footnoted rationales) by a second reviewer (see subsection w2 in the supplementary file). If effect estimates of a well conducted systematic review, meta-analysis, or network meta-analysis are incorporated to address parts of a key question of the rapid review, we advise using existing certainty of evidence grades from such systematic reviews. 16 Further details on assessing the certainty of evidence for rapid reviews are available. 16

Other best practice considerations

Recommendation 24: Provide a clear description of the selected rapid review approach, which includes outlining the restricted methods used. Additionally, discuss the potential limitations of these chosen methods and how they may influence the interpretation of the research findings

Describing the restricted methods used and pinpointing potential sources of bias or uncertainty in the findings resulting from methodological restrictions, enables end users to better assess the validity and reliability of the rapid review. This includes determining whether the methods were appropriate for the specific research question, studied population, and context being investigated. Additionally, this process serves to put the results in perspective, given the restrictions imposed by the methods of rapid reviews, helping to limit overgeneralisation of results or unwarranted conclusions.

Rapid reviews involve an iterative process

Sometimes, changes to the review protocol are necessary once a rapid review has started. For example, search variables may be expanded or limited depending on what the search yields, or eligibility criteria may need to be refined after the pilot screening. Therefore, the rapid review process should allow for post hoc changes to the protocol. Substantial changes should be discussed with the knowledge users involved, and any amendments should be tracked and reported in the rapid review. Moreover, authors should seek feedback from the knowledge users throughout the process to ensure the review meets their needs.

Incorporate the use of systematic review software to streamline the process

We strongly encourage using software to help produce rapid reviews to improve the efficiency of screening, tracking, and documentation, and to reduce human error. Online systematic review software enhances collaboration by allowing real time project management and multiuser participation across geographical boundaries. Importantly, the software enables members of the rapid review team to work in parallel across all stages of the review, and it provides a fully transparent process. It also facilitates the incorporation of protocol amendments and other post hoc changes that may be needed during the conduct of a rapid review. The use of software also increases efficiency through the automated collation of the screening results (inclusions and exclusions). Those undertaking rapid reviews and other types of syntheses should look for ways to harness innovation, using software and adopting automation tools that reliably assist in streamlining stages of a review’s conduct. One such example is Cochrane Crowd, which uses a machine learning platform and crowdsourcing to identify randomised controlled trials 8 (for examples, see SR ToolBox at http://systematicreviewtools.com/ ).

Apply appropriate reporting guidelines

Importantly, given the methodological modifications inherent to rapid reviews, authors must be transparent in reporting their methods and results. See the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) for reporting of rapid review protocols 32 and PRIMSA-S for searches. 38 Although an extension to PRISMA for rapid reviews is ongoing, 65 until it is officially completed we suggest authors use the general PRISMA statement 66 to the extent possible, and adapt it accordingly.

This updated guidance on methods used in Cochrane rapid reviews of effectiveness has the potential to benefit many producers and users of this review type. Although this guidance is heavily posited within the Cochrane landscape, the recommended methods apply widely to anyone conducting a rapid review. This guidance builds upon our interim guidance and is based on an evaluation of the recommendations used in real time, the expertise of a broader group of experts in rapid reviews within and external to Cochrane, and a scan of the literature for additional publications on rapid review methods since our recommendations were first published. Therefore, the recommendations are both evidence informed and user informed.

Noteworthy changes to the updated recommendations include modifications to search sources for both Cochrane and non-Cochrane rapid reviews of randomised controlled trials and for study selection at both the title and abstract and the full text screening stages, where the process has been simplified. Subsection w3 in the supplementary file provides a comparison between the interim and updated recommendations. In addition, a new section on certainty of evidence has been added as a separate element from the synthesis of results. Using appropriate reporting guidance for the protocol, search strategies and review itself are also emphasised. Importantly, further explanations and available examples are included to help clarify considerations and recommendations for methods in rapid reviews. Some additional practical tips for rapid review teams to increase efficiencies in the review process are also provided.

Although a multipronged approach, where more than one method restriction is combined, may increase timely production of reviews, users of this guidance can still label a review as a rapid review even if some of the recommendations are not followed. The key is that the pros and cons of each methodological restriction used in a rapid review should be weighed against the scope and complexity of the review topic and other circumstances of the review, including the timeline, number of team members involved at various stages of the review and their level of expertise, along with the potential for introducing bias. Rapid review teams therefore need expertise in systematic review methods to provide balanced methodological judgements when deciding which methods restrictions to use and how this might impact the findings of a particular review.

It is important to clarify the distinction between recommendations targeting Cochrane rapid reviews and those with a more general applicability. Some recommendations are tailored to Cochrane rapid reviews because they align with Cochrane’s standards, procedures, and objectives that do not apply to all contexts of rapid reviews. On the one hand, the guidance ensures that Cochrane rapid reviews consistently meet the organisation’s rigorous quality standards. On the other hand, certain recommendations have broader applicability across all methodologies and contexts of rapid reviews. These recommendations encompass fundamental principles and best practices that are not exclusive to Cochrane but are relevant for all rapid reviews of effectiveness. The recommendations address core aspects of conducting rapid reviews, such as the importance of involving knowledge users, use of protocols, transparency, and documentation, which are essential regardless of the specific review framework. Recognising that the methodology of rapid reviews is an evolving discipline with diverse applications, the guidance aims to balance between providing Cochrane specific direction and accommodating the broader community involved in rapid reviews. This approach acknowledges the need for flexibility and adaptability, enabling the authors of rapid reviews to apply relevant guidance while considering their specific requirements and objectives.

Our approach to the methods of rapid reviews stands out from existing guidance because it was crafted explicitly within the Cochrane context, concentrating on rapid reviews of interventions. In contrast, other guides for rapid reviews have targeted health policy and systems research, public health, or rapid guideline development during public health emergencies. 67 68 69 What also distinguishes our guidance is its sharp focus on the conduct of rapid reviews rather than planning, packaging, or dissemination. Notably, our recommendations for each step of the review process are specific, setting the guidance apart from others that typically offer a more general overview of common practices in rapid reviews. It is also worth noting that Cochrane rapid reviews are explicitly designed to address urgent and high priority questions requested by decision makers, aligning with a specific mandate that not all other guides necessitate. Although these other guides are also evidence informed and we encourage their use, our guide is uniquely grounded in empirical evidence evaluating methods of rapid reviews, 1 2 further enriched by expert input 13 14 15 16 and feedback from a formal evaluation of its real world use. 7

Although not all stages of a rapid review had corresponding evidence to inform the updated recommendation, as stated previously, we know that many established steps in the systematic review process are also based on evidence that is limited, outdated, or not available. Therefore, any future methodological research that informs rapid reviews will also be beneficial for systematic reviews. Future research should examine ways to adapt this guidance beyond interventions of effectiveness to other review question types, such as rapid reviews of diagnostic test accuracy or screening. Developing criteria for determining the appropriateness of undertaking rapid reviews versus systematic reviews or living systematic reviews would also be of value.

Optimising the review process, including study selection, data extraction, and synthesis of results, enables quicker production of rapid reviews. A variety of software tools, involving extraction of metadata, automation, screening software, and machine learning, have the potential to contribute to this optimisation. These tools aim to help streamline the review process, enhance transparency and reproducibility, and minimise reviewer bias. Collaboration software and live documents also facilitate real time exchanges, keeping all stakeholders in alignment throughout the process. Looking to the future, the potential of artificial intelligence (AI) will likely further advance the overall process for both rapid reviews and systematic reviews by providing intelligent assisted solutions to potentially speed up and increase efficiency of many review steps. AI may also reduce errors, improve accuracy, and improve repeatability and reproducibility of rapid reviews.

Overall, the Cochrane Rapid Reviews Methods Group offers updated, actionable recommendations to support the conduct of rapid reviews when the need for evidence is urgent. Because best practice is still limited by the lack of currently available evidence for some shortcuts used for rapid review methods, the Cochrane Rapid Review Methods Group will continue to promote research to close these gaps, monitor the published literature as additional abbreviated methods are formally evaluated, and update these recommendations as needed. Ultimately, we hope that uptake of this guidance will lead to more useful, robust, and rigorous rapid reviews, thus facilitating timely, evidence based decision making in healthcare.

Conclusions

This article offers updated guidance composed of 24 recommendations on methods for conducting rapid reviews of effectiveness produced within Cochrane and beyond to address urgent and high priority questions often requested by decision makers. The guidance aims to encourage the thoughtful use of best practices that are both user informed and evidence informed when applying abbreviated systematic review methods to rapid reviews.

Ethics statements

Ethical approval.

Not required.

Acknowledgments

We thank the collaborators who contributed to this updated guidance, and Piotr Ratajczak who updated the literature scan for newly published studies. We also thank our colleagues who worked with the convenors of the Cochrane Rapid Reviews Methods Group to create a series of articles in BMJ Evidence-Based Medicine. These articles give more details about the guidance we recommend in the current article. As such, we want to recognise these colleagues for their expertise in suggesting changes to the guidance: Andrea Tricco, Maureen Smith, Danielle Pollock, Irma Klerings, Shannon Robalino, Andrew Booth, Camila Micaela Escobar-Liquitay, Isolde Sommer, Siw Waffenschmidt, Anna Noel-Storr, Livia Puljak, Leila Kahwati, Meera Viswanathan, Amir Qaseem, Eli Akl, Holger Schuenemann, Jane Noyes, Catherine Houghton, Fiona Campbell, Anthea Sutton, Hanan Khalil, Lisa Affengruber, Miriam Van der Maten, James Thomas, Chris Mavergames, and René Spijker. In addition, a special thank you to Irma Klerings and Anna Noel-Storr for their specific review of the search related recommendations. We would also like to thank members of the Cochrane Methods Executive for reviewing and providing comments.

Contributors: CG, CH, MT, GG, BNS, DD, CK, UG, and VJK contributed to the conceptualisation of this paper. CG wrote the first draft of the manuscript and revised the manuscript with input from CH, MT, GG, BNS, DD, CK, UG, and VJK. All authors read and approved the final version. CG is the guarantor and attests that all authors meet authorship criteria and that no others meeting the criteria have been omitted.

Funding: This work was funded in part by Cochrane and in-kind support provided by Cochrane Austria, University for Continuing Education Krems, Krems, Austria. The funder had no role in the development of this guidance, writing of the report, or decision to submit the article for publication.

Competing interests: All authors have completed the ICMJE disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare: support from Cochrane for the submitted work. Certain methods studies upon which some of the recommendations are based have been carried out by authors of this guidance (GG, BNS, CH, CG, VJK, and CK). UG, BNS, and MT planned and carried out the evaluation study of the interim rapid review methods guidance.

Provenance and peer review: Not commissioned; externally peer reviewed.

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• Published: 30 July 2022

Paper 2: Performing rapid reviews

• Valerie J. King 1 ,
• Adrienne Stevens 2 ,
• Barbara Nussbaumer-Streit 3 ,
• Chris Kamel 4 &
• Chantelle Garritty 5  

Systematic Reviews volume  11 , Article number:  151 ( 2022 ) Cite this article

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Health policy-makers must often make decisions in compressed time frames and with limited resources. Hence, rapid reviews have become a pragmatic alternative to comprehensive systematic reviews. However, it is important that rapid review methods remain rigorous to support good policy development and decisions. There is currently little evidence about which streamlined steps in a rapid review are less likely to introduce unacceptable levels of uncertainty while still producing a product that remains useful to policy-makers.

This paper summarizes current research describing commonly used methods and practices that are used to conduct rapid reviews and presents key considerations and options to guide methodological choices for a rapid review.

The most important step for a rapid review is for an experienced research team to have early and ongoing engagement with the people who have requested the review. A clear research protocol, derived from a needs assessment conducted with the requester, serves to focus the review, defines the scope of the rapid review, and guides all subsequent steps. Common recommendations for rapid review methods include tailoring the literature search in terms of databases, dates, and languages. Researchers can consider using a staged search to locate high-quality systematic reviews and then subsequently published primary studies. The approaches used for study screening and selection, data extraction, and risk-of-bias assessment should be tailored to the topic, researcher experience, and available resources. Many rapid reviews use a single reviewer for study selection, risk-of-bias assessment, or data abstraction, sometimes with partial or full verification by a second reviewer. Rapid reviews usually use a descriptive synthesis method rather than quantitative meta-analysis. Use of brief report templates and standardized production methods helps to speed final report publication.

Conclusions

Researchers conducting rapid reviews need to make transparent methodological choices, informed by stakeholder input, to ensure that rapid reviews meet their intended purpose. Transparency is critical because it is unclear how or how much streamlined methods can bias the conclusions of reviews. There are not yet internationally accepted standards for conducting or reporting rapid reviews. Thus, this article proposes interim guidance for researchers who are increasingly employing these methods.

Peer Review reports

Introduction

Health policy-makers and other stakeholders need evidence to inform their decisions. However, their decisions must often be made in short time frames, and they may have other resource constraints, such as the available budget or personnel [ 1 , 2 , 3 , 4 , 5 , 6 ]. Rapid reviews are increasingly being used and are increasingly influential in the health policy and system arena [ 3 , 7 , 8 , 9 , 10 ]. One needs assessment [ 11 ] showed that policy-makers want evidence reviews to answer the right question, be completed in days to weeks, rather than months or years, be accurate and reproducible, and be affordable.

As much as policy-makers may desire faster and more efficient evidence syntheses, it is not yet clear whether rapid reviews are sufficiently rigorous and valid, compared to systematic reviews which are considered the “gold standard” evidence synthesis, to inform policy [ 12 ]. Only a few empirical studies have compared the findings of rapid reviews and systematic reviews on the same topic, and their results are conflicting and inconclusive, leaving questions about the level of bias that may be introduced because of rapid review methods [ 7 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ].

A standardized or commonly agreed-upon set of methods for conducting rapid reviews had not existed until recently, [ 1 , 9 , 14 , 20 , 21 , 22 , 23 ] and while there is little empiric evidence on some of the standard elements of systematic reviews, [ 24 ] those standards are well articulated [ 25 , 26 ]. A minimum interim set of standards has was developed by the Cochrane Rapid Reviews Methods Group [ 1 , 2 ] to help guide rapid review production during the SARS-CoV-19 pandemic, and other researchers have proposed methods and approaches to guide rapid reviews [ 5 , 21 , 22 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].

This article gives an overview of potential ways to produce a rapid review while maintaining a synthesis process that is sufficiently rigorous, yet tailored as needed, to support health policy-making. We present options for common methods choices, summarized from descriptions and evaluations of rapid review products and programs in Table 1 , along with key considerations for each methodological step.

The World Health Organization (WHO) published Rapid reviews to strengthen health policy and systems: a practical guide [ 5 ] in 2017. The initial work for this article was completed as a chapter for that publication and included multiple literature searches and layers of peer review to identify important studies and concepts. We conducted new searches using Ovid MEDLINE, the Cochrane Library’s methodology collection, and the bibliography of studies maintained by the Cochrane Rapid Reviews Methods Group, to identify articles, including both examples of rapid reviews and those on rapid review methodology, published after the publication of the WHO guide. We have not attempted to perform a comprehensive identification or catalog of all potential articles on rapid reviews or examples of reviews conducted with these methods. As this work was not a systematic review of rapid review methods, we do not include a flow of articles from search to inclusion and have not undertaken any formal critical appraisal of the articles we did include.

Needs assessment, topic selection, and topic refinement

Rapid reviews are typically conducted at the request of a particular decision-maker, who has a key role in posing the question, setting the parameters of the review, and defining the timeline [ 40 , 41 , 42 ]. The most common strategy for completing a rapid review within a limited time frame is to narrow its scope. This can be accomplished by limiting the number of questions, interventions, and outcomes considered in the review [ 13 , 15 ]. Early and continuing engagement of the requester and any other relevant stakeholders is critical to understand their needs, the intended use of the review, and the expected timeline and deliverables [ 15 , 28 , 29 , 40 , 41 , 42 ]. Policy-makers and other requesters may have vaguely defined questions or unrealistic expectations about what any type of review can accomplish [ 41 , 42 ]. A probing conversation or formal needs assessment is the critical first step in any knowledge synthesis approach to determine the scope of the request, the intended purpose for the completed review, and to obtain a commitment for collaboration over the duration of the project [ 28 , 30 , 41 ]. Once the request and its context are understood, researchers should fully develop the question(s), including any needed refinement with the requester or other stakeholders, before starting the project [ 5 ]. This process can be iterative and may require multiple contacts between the reviewers and the requester to ensure that the final rapid review is fit for its intended purpose [ 41 , 42 ]. In situations where a definitive systematic review might be needed, it may be useful to discuss with the requester the possibility of conducting a full systematic review, either in parallel or serially with the rapid review [ 43 ].

Protocol development

A research protocol clearly lays out the scope of the review, including the research questions and the approaches that will be used to conduct the review [ 44 ]. We suggest using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement for guidance [ 37 ]. Most reviewers use the PICO format (population, intervention, comparator, outcome), with some adding elements for time frame, setting, and study design. The PICO elements help to define the research questions, and the initial development of questions can point to needed changes in the PICO elements. For some types of research questions or data, other framework variations such as SPICE (setting, perspective, intervention, comparison, evaluation) may be used, although the PICO framework can generally be adapted [ 45 ]. Health services and policy research questions may call for more complex frameworks [ 5 ]. This initial approach assists both researchers and knowledge users to know what is planned and enables documentation of any protocol deviations; however, the customized and iterative nature of rapid reviews means that some flexibility may be required. Some rapid review producers include the concept of methods adjustment in the protocol itself [ 46 , 47 ]. However, changes made beyond the protocol stage and the rationale for making them must be transparent and documented in the final report.

The international prospective register of systematic reviews (PROSPERO) [ 44 ] ( https://www.crd.york.ac.uk/PROSPERO/ ) accepts registration of protocols that include at least one clinically or patient-relevant outcome. The Open Science Framework (OSF) [ 48 ] platform ( https://osf.io/ ) also accepts protocol registrations for rapid reviews. We advise protocol submitters to include the term “rapid review” or another similar term in the registered title, as this will assist tracking the use, validity, and value of rapid reviews [ 1 ]. Protocol registration helps to decrease research waste and allows both requesters and review authors to avoid duplication. Currently, most rapid review producers report using a protocol, but few register their protocols [ 13 , 17 ].

Literature search

Multiple authors have conducted inventories of the characteristics of and methods used for rapid reviews, including the broad categories of literature search, study selection, data extraction, and synthesis steps [ 13 , 15 , 17 , 20 , 24 , 49 ]. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards call for documentation of the full search strategy for all electronic databases used [ 38 ]. Most published rapid reviews search two or more databases, with PubMed, Embase, and the Cochrane Library mentioned frequently [ 13 , 17 , 20 , 49 ]. Rapid reviews often streamline systematic review methods by limiting the number of databases searched and the search itself by date, language, geographical area, or study design, and some rapid reviews search only for existing systematic reviews [ 13 , 15 , 17 , 20 , 49 , 50 ]. Other rapid reviews use a layered searching approach, identifying existing systematic reviews and then updating them with a summary of more recent eligible primary studies [ 13 , 15 , 18 , 20 , 36 ]. Studies of simplified search strategies have generally demonstrated acceptable retrieval characteristics for most types of rapid review reports [ 51 , 52 ]. Searching the reference lists of eligible studies (sometimes known as the “snowballing” technique) and searching the gray literature (i.e., reports that are difficult to locate or unpublished) are done in about half of published rapid reviews and may be essential for certain topics [ 13 , 15 , 20 , 49 ]. However, rapid reviews seldom report contact with authors and other experts to identify additional unpublished studies [ 13 , 15 , 20 , 49 ]. One study found that peer review of the search strategy, using a tool such as the PRESS (peer review of electronic search strategies) checklist, [ 39 ] was reported in 38% of rapid reviews, but that it was usually performed internally rather than by external information specialist reviewers [ 13 ]. Peer review of search strategies has been reported to increase retrieval of relevant records, particularly for nonrandomized studies [ 53 ].

Screening and study selection

Methodological standards for systematic reviews generally require independent screening of citations and abstracts by at least two researchers to arrive at a set of potentially eligible references, which are in turn subjected to dual review in full-text format to arrive at a final inclusion set. Rapid reviews often streamline this process, with up to 40% using a single researcher at each stage [ 13 , 15 , 17 , 18 , 20 , 49 ]. Some rapid reviews report verification of a sample of the articles by a second researcher or, occasionally, use of full dual screening by two independent researchers [ 13 , 17 , 20 , 49 ]. One methodological study reported that single screener selection missed an average of 5% of eligible studies, ranging from 3% for experienced reviewers and 6% for those with less experience [ 54 ]. If time and resources allow, we recommend that dual screening of all excluded studies, at both the title and full-text stages, be used to minimize the risk of selection bias through the inappropriate exclusion of relevant studies. However, there is some evidence that the use of a single experienced reviewer for particular topics may be sufficient [ 18 , 46 , 54 ].

Data extraction

As with citation screening and study selection, the number of independent reviewers who extract study data for a rapid review can vary. One study found that the most common approach is single-reviewer extraction (41%), although another 25% report verification of a sample by a second reviewer and nearly as many used dual extraction [ 13 ]. A more recent study reported that only about 10% of rapid reviews examined reported dual data extraction, although nearly twice as many simply did not report this feature [ 17 ]. Data abstraction generally includes PICO elements, although data abstraction was often limited by the scope of the review, and authors were contacted for missing data very infrequently [ 13 ].

Risk-of-bias assessment

Risk-of-bias assessment, sometimes called critical appraisal or methodological quality appraisal, examines the quality of the methods employed for each included study and is a standard element of systematic reviews [ 25 ]. The vast majority of rapid review producers perform some type of critical appraisal [ 17 , 20 ]. Some rapid reviews report the use of a single assessor with verification of a sample of study assessments by another assessor [ 17 , 49 ]. There is no consensus as to which risk-of-bias assessment tools should be used, although most reviews use study design-specific instruments (e.g., an instrument designed for randomized controlled trials (RCTs) if assessing RCTs) intended for assessing internal validity [ 13 , 20 ].

Knowledge synthesis

Nearly all rapid review producers conduct a descriptive synthesis (also often called a narrative synthesis) of results, but a few perform additional meta-analyses or economic analyses [ 13 , 17 , 20 ]. The synthesis that is conducted is often limited to a basic descriptive summary of studies and their results, rather than the full synthesis that is recommended for systematic reviews [ 26 ]. Most rapid reviews present conclusions, recommendations, or implications for policy or clinical practice as another component of the synthesis. Multiple experts also recommend that rapid reviews clearly describe and discuss the potential limitations arising from methodological choices [ 5 , 9 , 13 , 15 , 23 ].

Many systematic review producers use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system [ 55 ] ( http://www.gradeworkinggroup.org/ ) to rate the certainty of the evidence about health outcomes. Guideline developers and others who make recommendations or policy decisions use GRADE to rate the strength of recommendations based on that evidence. The GRADE evidence to decisions (EtD) framework has also been used to help decision-makers developing health system and public health [ 56 ] and coverage [ 57 ] policies. Rapid review authors can also employ GRADE to rate the certainty of synthesized evidence and develop policy implications for decision-makers if time and resources permit. However, the GRADE system works best for interventions that have been subject to RCTs and where there is at least one meta-analysis to provide a single estimate of effect.

Report production and dissemination

Standard templates for each stage of the review, from protocol development to report production, can assist the review team in performing each step efficiently. Use of a report template, with minimum methodological standards, reporting requirements, and standard report sections, can assist the producer in streamlining production of the report and can also enhance transparency [ 15 , 20 , 28 , 40 ]. An extension of the PRISMA statement for rapid reviews is under development and has been registered with the EQUATOR Network [ 58 ]. Until it is available, the PRISMA checklist for systematic reviews can serve as a reporting template to increase the transparency of rapid reviews [ 8 , 40 , 59 ].

Research about review formatting and presentation of rapid review is being conducted, but it is likely that the forms employed and tested will need to be adapted to the individual requester and stakeholder audiences [ 47 ]. Khangura and colleagues [ 28 ] have presented a figure showing formatted sections of a sample report, and many other rapid review producers have examples of reports online that can serve as formatting examples. In addition, findings from evidence summary presentation research for decision-makers in low- and middle-income countries can be translated into other settings [ 60 , 61 ].

Most rapid review producers conduct some form of peer review for the resulting reports, but such review is often internal and may include feedback from the requester [ 13 ]. Most producers disseminate their reports beyond the requester, but dissemination varies by the sensitivity or proprietary nature of the product [ 13 , 20 ]. When reports are disseminated, it is common for them to be posted online, for example, at an organizational website [ 13 , 20 ].

Operational considerations

Evaluations and descriptions of research programs that produce rapid reviews typically include some helpful pragmatic and operational considerations for undertaking a rapid review or developing a rapid review program [ 5 , 15 , 18 , 27 , 28 , 29 , 31 , 36 , 40 , 62 , 63 ]. Highly experienced, permanent staff with the right skill mix, including systematic reviewers, information specialists, methodologists, and content experts [ 15 , 18 , 30 , 40 , 49 ], are essential. It is time-consuming to assemble staff on a per-project basis, so the presence of an existing team (which may only do rapid reviews or may also do systematic reviews or other research) with review infrastructure already in place allows projects to get off to a quick start. The existence of a dedicated team also creates the potential to build relationships with requesters and to cultivate mutual trust. Staff with experience conducting systematic reviews will be familiar with standard methods and may be alert to any needed protocol changes as the review proceeds [ 49 ]. The rapid review team must understand the methodological implications of decisions taken and must convey these implications to the requesters, to allow them to understand the caveats and potential limitations. Continuing relationships and longer-term contracting with requesters, to allow for a quick start and “good faith” initiation of work before a contract is in place, can speed the early development stages [ 31 , 40 ]. It is important for rapid review producers to confirm that the choices they make to streamline the review are acceptable to the requester [ 41 ]. Whether it is a decision to limit the scope to a single intervention or outcome, restrict the literature search to existing systematic reviews, or forgo a meta-analysis, the knowledge user must be aware of the implications of streamlining decisions [ 15 , 27 , 31 , 41 ]. Some programs also emphasize the need for follow-up with review requesters to develop the relationship and continuously improve knowledge products [ 28 , 63 ]. Although it is beyond the scope of this article, we note that both systematic and rapid review producers are currently using various automated technologies to speed review production. There are examples of tools to help search for references, screen citations, abstract data, organize reviews, and enhance collaboration, but few evaluations of their validity and value in report production [ 64 , 65 ]. The Systematic Review Toolbox [ 66 ] ( http://systematicreviewtools.com/ ) is an online searchable database of tools that can help perform tasks in the evidence synthesis process.

Table 1 summarizes the commonly described approaches and key considerations for the major steps in a rapid review that are discussed in detail in the preceding sections.

Suggested approaches to rapid reviews

The previous sections have summarized the numerous approaches to conducting rapid reviews. Abrami and colleagues [ 27 ] summarized several methods of conducting rapid reviews and developed a brief review checklist of considerations and recommendations, which may serve as a useful parallel to Table 2 . A “one-size-fits-all” approach may not be suitable to cover the variety of topics and requester needs put forward. Watt and colleagues [ 9 ] observed over a decade ago, “It may not be possible to validate methodological strategies for conducting rapid reviews and apply them to every subject. Rather, each topic must be evaluated by thorough scoping, and appropriate methodology defined.” Plüddemann and colleagues [ 23 ] advocated for a flexible framework for what they term “restricted reviews,” with a set of minimum requirements and additional steps to reduce the risk of bias when time and resources allow. Thomas, Newman, and Oliver [ 29 ] noted that it might be more difficult to apply rapid approaches to questions of social policy than to technology assessment, in part because of the complexity of the topics, underlying studies, and uses of these reviews. The application of mixed methods, such as key informant interviews, stakeholder surveys, primary data, and policy analysis, may be required for questions with a paucity of published literature and those involving complex subjects [ 29 ]. However, rapid review producers should remain aware that streamlined methods may not be appropriate for all questions, settings, or stakeholder needs, and they should be honest with requesters about what can and cannot be accomplished within the timelines and resources available [ 31 ]. For example, a rapid review would likely be inappropriate as the foundation for a national guideline on cancer treatment due to be launched 5 years in the future. A decision tool, STARR (SelecTing Approaches for Rapid Reviews) has been published by Pandor and colleagues [ 67 ] to help guide decisions about interacting with report requesters, making informed choices regarding to the evidence base, methods for data extraction and synthesis, and reporting on the approaches used for the report.

Tricco and colleagues [ 21 ] conducted an international survey of rapid review producers, using a modified Delphi ranking to solicit opinions about the feasibility, timeliness, comprehensiveness, and risk of bias of six different rapid review approaches. Ranked best in terms of both risk of bias and feasibility was “approach 1,” which included published literature only, based on a search of one or more electronic databases, limited in terms of both date and language. With this approach, a single reviewer conducts study screening, and both data extraction and risk-of-bias assessment are done by a single reviewer, with verification by a second researcher. Other approaches were ranked best in terms of timeliness and comprehensiveness, [ 21 ] representing trade-offs that review producers and knowledge users may want to consider. Because the survey report was based on expert opinion, it did not provide empirical evidence about the implications of each streamlined approach [ 21 ]. However, in the absence of empirical evidence, it may serve as a resource for rapid review producers looking to optimize one of these review characteristics. Given that evidence regarding the implications of methodological decisions for rapid reviews is limited, we have developed interim guidance for those conducting rapid reviews (Table 2 ).

Rapid reviews are being used with increasing frequency to support clinical and policy decisions [ 6 , 22 , 34 ]. While policymakers are generally willing to trade some certainty for speed and efficiency, they do expect rapid reviews to come close to the validity of systematic reviews [ 51 ]. There is no universally accepted definition of a rapid review [ 2 ]. This lack of consensus is, in part, related to the grouping of products with different purposes, audiences, timelines, and resources. Although we have attempted to summarize the major choices available to reviewers and requesters of information, there are few empiric data to guide these choices. We may have missed examples of rapid reviews and methodological research that could add to the conclusions of this paper. However, our approach to this work has been pragmatic, much like a rapid review itself, and is based on our international experience as researchers involved in the Cochrane Rapid Reviews Methods Group, as well as authors who participated in the writing and dissemination of Rapid reviews to strengthen health policy and systems: a practical guide [ 5 ]. This paper has, in addition, been informed by our research about rapid reviews and our collective work across several groups that conduct rapid reviews [ 1 , 68 ]. The Cochrane Rapid Review Methods Group also conducted a methods opinion survey in 2019 and released interim recommendations to guide Cochrane rapid reviews during the SARS-CoV-2 pandemic [ 2 ]. These recommendations are specific to the needs of Cochrane reviews and offer more detailed guidance for rapid review producers than those presented in this paper. We encourage readers to sign up for the Cochrane Rapid Reviews Methods Group newsletter on the website ( https://methods.cochrane.org/rapidreviews/ ) and to check the list of methodological publications which is updated regularly to continue to learn about research pertinent to rapid reviews [ 68 ].

We have summarized the rapid review methods that can be used to balance timeliness and resource constraints with a rigorous knowledge synthesis process to inform health policy-making. Interim guidance suggestions for the conduct of rapid reviews are outlined in Table 2 . The most fundamental key to success is early and continuing engagement with the research requester to focus the rapid review and ensure that it is appropriate to the needs of stakeholders. Although the protocol serves as the starting point for the review, methodological decisions are often iterative, involving the requester. Any changes to the protocol should be reflected in the final report. Methods can be streamlined at all stages of the review process, from search to synthesis, by limiting the search in terms of dates and language; limiting the number of electronic databases searched; using one reviewer to perform study selection, risk-of-bias assessment, and data abstraction (often with verification by another reviewer); and using a descriptive synthesis rather than a quantitative summary. Researchers need to make transparent methodological choices, informed by stakeholder input, to ensure that the evidence review is fit for its intended purpose. Given that it is not clear how these choices can bias a review, transparency is essential. We are aware that an increasing number of journals publish rapid reviews and related evidence synthesis products, which we hope will further increase the availability, transparency, and empiric research base for progress on rapid review methodologies.

Abbreviations

Enhancing the QUAlity and Transparency Of health Research

Grading of Recommendations Assessment, Development and Evaluation

Population, intervention, comparator, outcomes

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocols

Randomized controlled trial

Setting, Perspective, Intervention, Comparator, Evaluation

SelecTing Approaches for Rapid Reviews

Peer review of electronic search strategies

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Time to produce this manuscript was donated in kind by the authors’ respective organizations, but no other specific funding was received alliance for health policy and systems research,norwegian government agency for development cooperation, swedish international development cooperation agency, department for international development, uk government

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Valerie J. King

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Adrienne Stevens

Cochrane Austria, Danube University Krems, Krems, Austria

Barbara Nussbaumer-Streit

Canadian Agency for Drugs and Technologies in Health, Ottawa, Canada

Chris Kamel

Global Health & Guidelines Division, Public Health Agency of Canada, Ottawa, Canada

Chantelle Garritty

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King, V.J., Stevens, A., Nussbaumer-Streit, B. et al. Paper 2: Performing rapid reviews. Syst Rev 11 , 151 (2022). https://doi.org/10.1186/s13643-022-02011-5

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How to Do a Rapid Review of Peer-Reviewed Literature

• Watching now: Chapter 1: Robert Kerrison Introduces and Defines Rapid Literature Reviews Start time: 00:00:00 End time: 00:03:43
• Chapter 2: Robert Kerrison Discusses Research Questions, Principal Components, and Search Terms as Steps of a Rapid Literature Review Start time: 00:03:44 End time: 00:07:38
• Chapter 3: Robert Kerrison Discusses Databases, Eligibility Criteria, and an Initial Search as Steps of a Rapid Literature Review Start time: 00:07:39 End time: 00:11:25
• Chapter 4: Robert Kerrison Discusses Successive Searches as a Step of a Rapid Literature Review Start time: 00:11:26 End time: 00:15:33
• Chapter 5: Robert Kerrison Discusses Full-Paper Reviews, Reference Lists, and Data Extraction and Analysis as Steps of a Rapid Literature Review Start time: 00:15:34 End time: 00:19:57

Video Type: Tutorial

Kerrison, R. (Academic). (2021). How to do a rapid review of peer-reviewed literature [Video]. Sage Research Methods. https:// doi. org/10.4135/9781529779479

Kerrison, Robert. "How to Do a Rapid Review of Peer-Reviewed Literature." In Sage Video . : SAGE Publications, Ltd., 2021. Video, 00:19:57. https:// doi. org/10.4135/9781529779479.

Kerrison, R., 2021. How to Do a Rapid Review of Peer-Reviewed Literature , Sage Video. [Streaming Video] London: Sage Publications Ltd. Available at: <https:// doi. org/10.4135/9781529779479 & gt; [Accessed 18 Nov 2024].

Kerrison, Robert. How to Do a Rapid Review of Peer-Reviewed Literature . Online video clip. SAGE Video. London: SAGE Publications, Ltd., 3 Sep 2021. doi: https:// doi. org/10.4135/9781529779479. 18 Nov 2024.

How to Do a Rapid Review of Peer-Reviewed Literature [Streaming video]. 2021. doi:10.4135/9781529779479. Accessed 11/18/2024

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Supplementary material

Robert Kerrison, Senior Research Fellow at the Department of Behavioural Science and Health, University College London, discusses how to do a rapid review of peer-reviewed literature, including the strengths and limitations, and situations where a rapid review is warranted, and steps to conducting a rapid literature review.

Chapter 1: Robert Kerrison Introduces and Defines Rapid Literature Reviews

• Start time: 00:00:00
• End time: 00:03:43

Chapter 2: Robert Kerrison Discusses Research Questions, Principal Components, and Search Terms as Steps of a Rapid Literature Review

• Start time: 00:03:44
• End time: 00:07:38

Chapter 3: Robert Kerrison Discusses Databases, Eligibility Criteria, and an Initial Search as Steps of a Rapid Literature Review

• Start time: 00:07:39
• End time: 00:11:25

Chapter 4: Robert Kerrison Discusses Successive Searches as a Step of a Rapid Literature Review

• Start time: 00:11:26
• End time: 00:15:33

Chapter 5: Robert Kerrison Discusses Full-Paper Reviews, Reference Lists, and Data Extraction and Analysis as Steps of a Rapid Literature Review

• Start time: 00:15:34
• End time: 00:19:57
• Product: Sage Research Methods Video: Medicine and Health
• Type of Content: Tutorial
• Title: How to Do a Rapid Review of Peer-Reviewed Literature
• Publisher: SAGE Publications, Ltd.
• Publication year: 2021
• Online pub date: September 03, 2021
• Discipline: Medicine
• Methods: Rapid review , Literature review , Systematic review
• Duration: 00:19:57
• DOI: https:// doi. org/10.4135/9781529779479
• Keywords: data analysis , data collection , eligibility determination , literature reviews , literature search , literature searches , medical databases , medical research , principal component analysis , research methodology , research questions , Search strategies , Systematic reviews Show all Show less

Academic: Robert Kerrison

Further Reading Duffy , S.W. , Myles , J.P. , Maroni , R. , & Mohammad, A. , ( 2017 ). Rapid review of evaluation of interventions to improve participation in cancer screening services . Journal of Medical Screening , 24 ( 3 ), 127-145 . http://dx.doi.org/10.1177/0969141316664757 https://journals.sagepub.com/doi/10.1177/0969141316664757?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

Further Reading Kerrison , R.S. , von Wagner , C. , Green , T. , & Et al. , ( 2019 ). Rapid review of factors associated with flexible sigmoidoscopy screening use . Preventive Medicine , 120 , 8-18 . http://dx.doi.org/10.1016/j.ypmed.2018.12.018

Further Reading Kerrison , R.S. , von Wagner , C. , Ghanouni , A. , & Et al. , ( 2020 ). Lessons Learned From Conducting a Rapid Review: A Case Study Examining Factors Associated With Flexible Sigmoidoscopy Screening Use . SAGE Research Methods Cases: Medicine and Health , http://dx.doi.org/10.4135/9781529718164 https://methods.sagepub.com/case/conducting-rapid-review-factors-flexible-sigmoidoscopy-screening-use

Further Reading Kerrison , R.S. , Sheik-Mohamud , D. , McBride , E. , & Et al. , ( 2021 ). Patient barriers and facilitators of colonoscopy use: A rapid systematic review and thematic synthesis of the qualitative literature . Preventive Medicine , 145 , http://dx.doi.org/10.1016/j.ypmed.2020.106413

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A Guide to Conducting Reviews: Rapid Review

• Literature Review
• Systematic Review
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Online Standards and Guides

Practical Guide for Rapid Reviews

Rapid review guidebook: steps for conducting a rapid review.

Definition : A form of knowledge synthesis that applies systematic review methodology within a time-constrained setting. That is, the components or steps of the systematic review process are simplified, accelerated/fast-tracked, or omitted/side-stepped to produce information in a shortened timeframe.

Aim : To expedite the conduct of reviews to inform health policy and systems decisions, and to provide actionable and relevant evidence in a timely and cost-effective manner.

Key characteristics:  A rapid review is best designed for new or emerging research topics, updates of previous reviews, critical topics, to assess what is already known about a policy or practice.

Main steps :

• Identify a research topic and frame a narrow research question
• Select your study inclusion and exclusion criteria (e.g. time period, language, location, age range, animal or human studies, type of published material)
• Create a study search protocol using keywords from the research question
• Plan and execute a literature search using a key database
• Store all citations and maintain a record
• Screen your results to select eligible documents
• Report for publication

Strengths: Useful for addressing issues that need quick decisions. Faster time to completion, typically done in 5 weeks up to 3 months.

Drawbacks/Limitations : Risk of missing the significance of a theme that emerges from the literature. Greater chance of bias. Limited appraisal and assessment. Limitation of the search not being comprehensive.

Source : Cochrane Training. (2018, August 22).  Difference between systematic reviews and rapid reviews  [Video]. YouTube. https://www.youtube.com/watch?v=JDX_rWKCRVs&t=185s

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