Background:
Public health decision makers need to be able to easily access high-quality synthesized evidence in order to apply research to policy and programming decisions. This is of the utmost importance in times of crises when resources become additionally strained, and decisions still need to be made quickly. As the COVID-19 pandemic continues, decisions are based on rapidly evolving evidence of varying quality. In response to this challenge the National Collaborating Centre for Methods and Tools (NCCMT) developed a Rapid Evidence Service, building on internationally accepted rapid review methodologies, to synthesize the best available evidence on priority COVID-19 public health questions for local, regional, and national public health decision makers.
Methods:
Our process involves: framing prioritized topics received from public health decision makers into searchable questions; developing and conducting a comprehensive search; rapid screening for relevance and minimizing duplication of efforts; critically appraising relevant evidence using validated tools; summarizing key findings from individual studies; GRADEing the evidence; and synthesizing the findings into a final report that includes an overall summary and key messages along with the certainty of the findings, and an overview of remaining knowledge gaps. Our team includes members with specialized expertise in synthesis methods and we collaborate with content-specific experts to ensure accuracy and applicability, as needed. Public partners are also invited to provide their perspectives and lived experiences to inform question development and review conclusions, to ensure the needs of those who are most affected by subsequent decisions are represented. We have improved the efficiency of our process while maintaining methodological rigour by using collaborative systematic review technologies and building upon already completed syntheses where available.
Results:
We have conducted 70 rapid review or review updates since the onset of the COVID-19 pandemic to address priority public health questions and continue to update completed reviews as new evidence emerges. Our rapid review process has evolved to ensure feasibility, accuracy, and efficiency as the pandemic and its evidence landscape changes. Webpage analytics demonstrate reviews are highly accessed across Canada. While we are planning a formal evaluation of our process and impact, preliminary feedback has shown that this service is helpful, timely, and informative. Public partner engagement throughout the rapid evidence review process brings additional insights that improve the relevance of reviews for decision making. We have developed standards to present the citizen input in the review document, whether pulled out separately from the research summary or incorporated along with the summary of findings, to aid policymakers in applying this information to decisions.
Conclusions:
Our rapid evidence process is a real-world example of how review-level evidence can be mobilized – rapidly, reliably, and needs-driven – during such unprecedented times. By incorporating public partners into the review process, we represent the perspectives and lived experiences of those most affected by decisions to policymakers.
Emily Clark slides