Abstract
BackgroundTo provide evidence synthesis for faster-paced healthcare decision-making, rapid reviews have emerged as a streamlined alternative to standard systematic reviews. In 2012, the Veterans Affairs Evidence-based Synthesis Program (VA ESP) added rapid reviews to support Veterans Health Administration (VHA) operational partners’ more urgent decision-making needs. VHA operational partners play a substantial role in dissemination of ESP rapid reviews through a variety of routes, including posting on the VA ESP’s public website (http://www.hsrd.research.va.gov/publications/esp/). As demand for rapid reviews rises, much progress has been made in characterizing methods and practices. However, evidence synthesis organizations still seek to better understand how and when rapid reviews are being used.MethodsThe VA ESP administered an online survey to rapid review operational partners. The survey assessed the nature of decision-making needs, overall perception of review content, resulting actions, and implementation timeframe. We use descriptive statistics and narrative methods to summarize findings.ResultsBetween October 2011 and April 2015, we completed 12 rapid reviews for 35 operational partners. Operational partners were primarily non-academic subject matter experts with VA operations’ decision-making authority. The most common topic categories reviewed were policy or system (50 %) or process of care (42 %) initiatives. Median report completion time was 14.5 weeks. Survey response rate was 46 %, with at least one operational partner responding for 92 % of reports. Reviews served multiple purposes including policy directive or regulation (72 %), supporting program development and evaluation (55 %), identifying future research needs (45 %), and determining implementation strategy (45 %). Overall, operational partners’ perception of report content was positive. A majority of rapid reviews were used immediately and informed actions ranking high on the Institute of Medicine’s Degrees of Impact framework: 45.4 % effected change, 18.2 % inspired action, 18.2 % informed the field, 9.1 % received recognition, and 9.1 % spread a message.ConclusionsVA ESP rapid reviews have increased the VHA’s uptake of evidence to inform time-sensitive system-level decision-making. Key areas of interest for future evaluation include assessing user perception of our streamlined methods and the quality of our efforts to inform users of these methods, as well as comparing the usability and impact of our rapid and standard systematic reviews.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0306-5) contains supplementary material, which is available to authorized users.
Highlights
To provide evidence synthesis for faster-paced healthcare decision-making, rapid reviews have emerged as a streamlined alternative to standard systematic reviews
Hartling et al [4] grouped rapid review products into the following four categories based on the extent of synthesis: (1) “inventories” provide a listing of the available evidence, within 3 days to 6 months; (2) “rapid responses” present the best available evidence with no formal synthesis, within 5 days to 3 months, and often rely on secondary sources; (3) “rapid reviews” synthesize the quality of and findings from the evidence, generally within 2 to 4 months; and (4) “automated approaches” generate meta-analyses in response to user-defined queries
The Veterans Affairs (VA) Evidence-based Synthesis Program (ESP) Evidence-based Synthesis Program Coordinating Center (CC) drafted the initial survey instrument based on the Quality Enhancement Research Initiative (QUERI) Strategic Plan, the Veterans Health Administration (VHA) Strategic Plan (“Blueprint for Excellence”), and their linkage to the goals of the ESP
Summary
To provide evidence synthesis for faster-paced healthcare decision-making, rapid reviews have emerged as a streamlined alternative to standard systematic reviews. To meet time-sensitive demands for quality evidence, rapid reviews have emerged as a streamlined alternative to standard systematic reviews [1,2,3,4,5,6,7]. Hartling et al [4] grouped rapid review products into the following four categories based on the extent of synthesis: (1) “inventories” provide a listing of the available evidence, within 3 days to 6 months; (2) “rapid responses” present the best available evidence with no formal synthesis, within 5 days to 3 months, and often rely on secondary sources; (3) “rapid reviews” synthesize the quality of and findings from the evidence, generally within 2 to 4 months; and (4) “automated approaches” generate meta-analyses in response to user-defined queries. Concern has been raised that streamlining may compromise the quality of the work and increase the risk of missing evidence or errors in the synthesis, decreasing utility to end users [3, 4]
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