Abstract
BackgroundA number of methods for deciding when a systematic review should be updated have been proposed, yet little is known about whether systematic reviews are updated more quickly when new evidence becomes available. Our aim was to examine the timing of systematic review updates relative to the availability of new evidence.MethodsWe performed a retrospective analysis of the update timing of systematic reviews published in the Cochrane Database of Systematic Reviews in 2010 relative to the availability of new trial evidence. We compared the update timing of systematic reviews with and without signals defined by the completion or publication of studies that were included in the updates.ResultsWe found 43% (293/682) systematic reviews were updated before June 2017, of which 204 included an updated primary outcome meta-analysis (median update time 35.4 months; IQR 25.5–54.0), 38% (77/204) added new trials, and 4% (8/204) reported a change in conclusion. In the 171 systematic reviews with reconcilable trial reporting information, we did not find a clear difference in update timing (p = 0.05) between the 15 systematic reviews with a publication signal (median 25.3 months; IQR 15.3–43.5) and the 156 systematic reviews without a publication signal (median 34.4 months; IQR 25.1–52.2). In the 145 systematic reviews with reconcilable trial completion information, we did not find a difference in update timing (p = 0.33) between the 15 systematic reviews with a trial completion signal (median 26.0 months; IQR 19.3–49.5) and the 130 systematic reviews without a trial completion signal (median 32.4 months; IQR 24.1 to 46.0).ConclusionA minority of 2010 Cochrane reviews were updated before June 2017 to incorporate evidence from new primary studies, and very few updates led to a change in conclusion. We did not find clear evidence that updates were undertaken faster when new evidence was made available. New approaches for finding early signals that a systematic review conclusion is at risk of change may be useful in allocated resources to the updating of systematic reviews.
Highlights
A number of methods for deciding when a systematic review should be updated have been proposed, yet little is known about whether systematic reviews are updated more quickly when new evidence becomes available
There were 773 articles published in the Cochrane Database of Systematic Reviews in 2010, of which 682 systematic reviews were included in the study
Of the 293 systematic reviews that were updated, 204 (69.6%) included a primary outcome meta-analysis. This included 60 systematic reviews that had new trials added to a primary outcome meta-analysis in the update, 111 that included no new trials in a primary outcome meta-analysis, 17 that added new non-English trials, and 16 that had outcomes or populations that were substantially different from the systematic review that was updated (Fig. 2; Additional file 1)
Summary
A number of methods for deciding when a systematic review should be updated have been proposed, yet little is known about whether systematic reviews are updated more quickly when new evidence becomes available. Our aim was to examine the timing of systematic review updates relative to the availability of new evidence. Systematic reviews provide an important source of clinical evidence for informing policy and health decision-making [1,2,3,4], but need to be kept up to date to avoid the potential for unnecessary waste or harm in clinical decision-making [5, 6]. Updating a systematic review is a resource-intensive process and ensuring that they are kept up to date is a challenge. The recommendations produced by the Cochrane Collaboration have changed over time to match the availability of resources and adapt to new methods and technologies designed to support the process [12,13,14]
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