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Quick but Not Dirty: Rapid Evidence Assessments as a Decision Support Tool in Social Policy

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... As one of the leaders in evidence synthesis methods and online evidence retrieval systems, the JBI has a background in the development of methods and methodology for rapid reviews and evidence summaries (Campbell et al., 2014;Munn, Kavanagh, Lockwood, Pearson, & Wood, 2013). Other organizations and groups have created their own methods for rapid reviews or evidence summaries (Butler, Deaton, Hodgkinson, Holmes, & Marshall, 2005;Harker & Kleijnen, 2012;Khangura et al., 2012). This paper outlines our experience of developing evidence summaries in the context of a point of care resource as a contribution to the emerging field of rapid review methodologies. ...
... As with all rapid reviews, there is a balance between development time and rigor (Butler et al., 2005;Grant & Booth, 2009;Wyer & Rowe, 2007). It has been shown that the more rapid reviews adhere to systematic review methodology, the longer they take to complete. ...
... As we offer a clinical information resource designed to be used at the point of care, we frequently receive requests from healthcare professionals asking for a summary of the literature on a certain topic, a service we provide freely to subscribers. In this way our evidence summaries are akin to rapid evidence assessments which are a quick, clean decision support tool (Butler et al., 2005). The need for clarity and transparency in methods is all the more important given the rapidity of development, and necessitates a robust internal and external peer review process. ...
Article
A systematic review of evidence is the research method which underpins the traditional approach to evidence-based health care. As systematic reviews follow a rigorous methodology, they can take a substantial amount of time to complete ranging in duration from 6 months to 2 years. Rapid reviews have been proposed as a method to provide summaries of the literature in a more timely fashion. The aim of this paper is to outline our experience of developing evidence summaries in the context of a point of care resource as a contribution to the emerging field of rapid review methodologies. Evidence summaries are defined as a synopsis that summarizes existing international evidence on healthcare interventions or activities. These summaries are based on structured searches of the literature and selected evidence-based healthcare databases. Following the search, all studies are assessed for internal validity using an abridged set of critical appraisal tools. Once developed, they undergo three levels of peer review by internal and external experts. As of November 2014, there are 2458 evidence summaries that have been created across a range of conditions to inform evidence-based healthcare practices. In addition, there is ongoing development of various new evidence summaries on a wide range of topics. Approximately 60-70 new evidence summaries are published every month, covering research in various medical specialty areas. All summaries are updated annually. Systematic reviews, although the ideal type of research to inform practice, often do not meet the needs of users at the point of care. This article describes the development framework for the creation of evidence summaries, a type of rapid review. Although evidence summaries may result in a less rigorous process of development, they can be useful for improving practice at the point of care. © 2015 Sigma Theta Tau International.
... To address requests for literature reviews in shorter time periods and to facilitate informed decision-making and understand the credibility of rapid reviews, their methods should be explicit and transparent [59]. Butler [60], studying rapid assessments, identified that selection bias, publication bias and language of publication bias may be introduced when using literature that is readily accessible to a researcher. Ganann et al. [58] noted that rapid reviews with shorter timeframes (1-3 months) were often less systematic in their search for evidence than those with longer timeframes (3-6 months). ...
... However, they found that, although the scope of rapid reviews is limited, they can provide adequate advice for clinical and policy decisions. For RG developers, considering the amount of resources required to maintain quality in a short timeframe remains a challenge but can be overcome by working in larger and qualified teams [59,60]. In fact, remaining systematic in the identification and use of evidence is equally important for RGs as it is for standard guidelines and RGs should not rely on expert opinion without stating the evidence from which this opinion is formed. ...
Article
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Background: Guidelines in the healthcare field generally should contain evidence-based recommendations to inform healthcare decisions. Guidelines often require 2 years or more to develop, but certain circumstances necessitate the development of rapid guidelines (RGs) in a short period of time. Upholding methodological rigor while meeting the reduced development timeframe presents a challenge for developing RGs. Our objective was to review current practices and standards for the development of RGs. This is the first of a series of three articles addressing methodological issues around RGs. Methods: We conducted a systematic survey of methods manuals and published RGs to identify reasons for the development of RGs. Data sources included existing guideline manuals, published RGs, Trip Medical Database, MEDLINE, EMBASE and communication with guideline developers until February 2018. Results: We identified 46 guidelines that used a shortened timeframe for their development. Nomenclature describing RGs varied across organisations, wherein the United States Centers for Disease Control and Prevention produced 'Interim Guidelines', the National Institute for Health and Care Excellence in the United Kingdom developed 'Short Clinical Guidelines', and WHO provided 'Rapid Advice'. The rationale for RGs included response to emergencies, rapid increases in cases of a condition or disease severity, or new evidence regarding treatment. In general, the methods to assess the quality of evidence, the consensus process and the management of the conflict of interest were not always clear. While we identified another 11 RGs from other institutions, there was no reference to timeframe and reasons for conducting a RG. The three organisations mentioned above provide guidance for the development of RGs. Conclusions: There is a lack of standardised nomenclature and definitions regarding RGs and there is inconsistency in the methods described in manuals and in RG. It is therefore important that all RGs provide a detailed and transparent description of their methods in order for readers and end-users to be able to assess their quality and validate their findings.
... Thus, methods are continually being sought to speed up the process of completing systematic reviews in order for them to dovetail more closely with policy and practice decision-making timescales. The 'rapid evidence assessment' (REA), which has been labelled by some as being a new type of review, has been promoted as being a potential solution to this problem (Hailey et al, 2000; Burton et al, 2007; Khangura et al, 2012). The REA (or rapid review, or brief review) is essentially an attempt to obtain compromise between the expectation that a systematic review delivers the most rigorous and comprehensive synthesis of the available evidence base, and the requirement from the policy-making process for evidence to be available in a timely manner. ...
... The main difference between an REA and a systematic review in social policy, according to Burton et al (2007) (who have themselves completed at least one REA), is in the extent of their searches: 'exhaustive database searching, hand searching of journals and textbooks, and searching of " grey " literature are not immediately undertaken' (2007: 2). Abrami et al (2010) have examined some of these additional characteristics of REAs and describe them as being 'brief reviews' in order to stress that they may not only take less time to complete than systematic reviews, but are also often reduced in scope and that reductions in scope result in limitations in: ...
Article
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There is a tension between conducting comprehensive systematic reviews and completing them in time to meet policy-making deadlines. The 'rapid evidence assessment' has been proposed as a solution to this; offering rigorous reviews in a condensed timescale. While used frequently in healthcare, this mode of reviewing presents considerable challenges in social policy. We describe some potential problems and suggest reviewing strategies that can overcome some of them. There are situations, however, in which it may not be feasible to embark on a rapid review, and caution should be exercised when selecting this method.
... To provide timely and responsive advice the search process is accelerated and the findings of existing systematic reviews emphasised, but some harder to find material in the grey literature may be missed. This may introduce biases and it has been suggested that rapid reviews should carry a warning to the effect that guidance may be revised if and when a relevant systematic review is published [5]. There is increasing recognition that improving the detection, treatment and outcomes for mental health problems requires service models that integrate mental health care within primary health care practice [6]. ...
... Butler noted that overcoming local organisational and cultural barriers requires strong leadership to champion change [5].Shared governance arrangements between primary care and specialist services were found to support faithful application of evidence-based shared care models [60,68,69]. Such clinical governance was needed to promote (1) clear, agreed lines of clinical accountability , (2) clinically appropriate interventions linked with clear methods to ensure appropriate clinical supervision of staff [17,70], and (3) appropriate evaluation of the " shared care " model [17,39,50,52] . ...
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While integrated primary healthcare for the management of depression has been well researched, appropriate models of primary care for people with severe and persistent psychotic disorders are poorly understood. In 2010 the NSW (Australia) Health Department commissioned a review of the evidence on "shared care" models of ambulatory mental health services. This focussed on critical factors in the implementation of these models in clinical practice, with a view to providing policy direction. The review excluded evidence about dementia, substance use and personality disorders. A rapid review involving a search for systematic reviews on The Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects (DARE). This was followed by a search for papers published since these systematic reviews on Medline and supplemented by limited iterative searching from reference lists. Shared care trials report improved mental and physical health outcomes in some clinical settings with improved social function, self management skills, service acceptability and reduced hospitalisation. Other benefits include improved access to specialist care, better engagement with and acceptability of mental health services. Limited economic evaluation shows significant set up costs, reduced patient costs and service savings often realised by other providers. Nevertheless these findings are not evident across all clinical groups. Gains require substantial cross-organisational commitment, carefully designed and consistently delivered interventions, with attention to staff selection, training and supervision. Effective models incorporated linkages across various service levels, clinical monitoring within agreed treatment protocols, improved continuity and comprehensiveness of services. "Shared Care" models of mental health service delivery require attention to multiple levels (from organisational to individual clinicians), and complex service re-design. Re-evaluation of the roles of specialist mental health staff is a critical requirement. As expected, no one model of "shared" care fits diverse clinical groups. On the basis of the available evidence, we recommended a local trial that examined the process of implementation of core principles of shared care within primary care and specialist mental health clinical services.
... Bias can be introduced in many ways through the methodological approach to study location and selection [22]. Butler et al. outlined methods used in rapid evidence assessments (REAs), and acknowledged that selection bias, publication bias, and language of publication bias may be introduced when using literature that is readily accessible to a researcher [23]. Within their REAs, exhaustive database searching, hand searching, and grey literature searching is not initially undertaken. ...
... Some literature has identified that inclusion of non- English studies can impact treatment effects; the literature is unclear, however, about the nature of this impact [37]. Butler et al. suggested that all rapid evidence assessments should carry the caveat that conclusions may be subject to change and/or revision once a more systematic review has been completed [23]. The Magenta Book also suggests that all rapid reviews should carry a similar qualifying statement [20]. ...
Article
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Policy makers and others often require synthesis of knowledge in an area within six months or less. Traditional systematic reviews typically take at least 12 months to conduct. Rapid reviews streamline traditional systematic review methods in order to synthesize evidence within a shortened timeframe. There is great variation in the process of conducting rapid reviews. This review sought to examine methods used for rapid reviews, as well as implications of methodological streamlining in terms of rigour, bias, and results. A comprehensive search strategy--including five electronic databases, grey literature, hand searching of relevant journals, and contacting key informants--was undertaken. All titles and abstracts (n = 1,989) were reviewed independently by two reviewers. Relevance criteria included articles published between 1995 and 2009 about conducting rapid reviews or addressing comparisons of rapid reviews versus traditional reviews. Full articles were retrieved for any titles deemed relevant by either reviewer (n = 70). Data were extracted from all relevant methodological articles (n = 45) and from exemplars of rapid review methods (n = 25). Rapid reviews varied from three weeks to six months; various methods for speeding up the process were employed. Some limited searching by years, databases, language, and sources beyond electronic searches. Several employed one reviewer for title and abstract reviewing, full text review, methodological quality assessment, and/or data extraction phases. Within rapid review studies, accelerating the data extraction process may lead to missing some relevant information. Biases may be introduced due to shortened timeframes for literature searching, article retrieval, and appraisal. This review examined the continuum between diverse rapid review methods and traditional systematic reviews. It also examines potential implications of streamlined review methods. More of these rapid reviews need to be published in the peer-reviewed literature with an emphasis on articulating methods employed. While one consistent methodological approach may not be optimal or appropriate, it is important that researchers undertaking reviews within the rapid to systematic continuum provide detailed descriptions of methods used and discuss the implications of their chosen methods in terms of potential bias introduced. Further research comparing full systematic reviews with rapid reviews will enhance understanding of the limitations of these methods.
... Rapid reviews aim to be rigorous and explicit in method and thus systematic but make concessions to the breadth or depth of the process by limiting particular aspects of the review process (Butler et al., 2005). The methodology identifies several legitimate techniques that Dunn, Gottlicher-Hill & Stephens, Melbourne Graduate School of Education, The University of Melbourne, 2022 6 may be used to shorten the timescale. ...
Research
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The purpose of this academic literature review is to identify promising practices in the teaching of mathematics online that emerged as a result of the COVID-19 pandemic. The review scanned international literature to identify key principles related to effective online teaching of mathematics.
... La revisión rápida (rapid review) (Butler et al., 2005) se utiliza para evaluar lo que ya se sabe sobre una cuestión política o práctica, utilizando métodos de revisión sistemática para buscar y evaluar críticamente la investigación existente. Ejemplos de este tipo de revisiones podrían ser (Bryant & Gray, 2006;Cardwell et al., 2022). ...
Article
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La revisión sistemática de literatura es un método sistemático para identificar, evaluar e interpretar el trabajo de académicos y profesionales en un campo elegido. Su propósito es identificar lagunas en el conocimiento y necesidades de investigación en un campo concreto. Las revisiones sistemáticas conforman una familia amplia de métodos y aproximaciones y resultan totalmente necesarias por el volumen tan enorme de producción científica en formato digital al que se tiene potencialmente acceso. Sin embargo, no es suficiente con adjetivar una revisión como sistemática. El objetivo de este artículo es presentar las diferentes fases que se deben llevar a cabo cuando se realiza una revisión sistemática. Se comienza con la introducción de los marcos metodológicos de referencia para la realización de revisiones sistemáticas, para, a continuación, profundizar en las fases de planificación, realización e informe de la revisión sistemática. De modo que todo artículo que lleve este marbete (revisión sistemática de literatura) además de cumplir unos principios metodológicos y de transparencia, permita que cualquier investigador pueda no solo confiar en las conclusiones derivadas del trabajo, sino evolucionar la revisión sistemática realizada para atacar el problema derivado de la obsolescencia y el continuo avance del conocimiento científico, en consonancia con el modelo de datos FAIR, es decir, que se cumplen con los principios de encontrabilidad, accesibilidad, interoperabilidad y reutilización. Este artículo se ha escrito en español y en inglés.
... A consulta pública pode A redação da diretriz rápida pode ser realizada concomitantemente às reuniões do painel, contribuindo para a celeridade do processo (106), e deve considerar fatores como a implementação e a importância do contexto na formulação das recomendações, pois a maioria das evidências de pesquisa provavelmente foi gerada em contextos e populações diferentes da emergência de saúde pública em questão. Além disso, torna-se particularmente importante descrever os possíveis vieses que podem ter sido introduzidos no processo de desenvolvimento de uma diretriz rápida (102), uma vez que avaliações rápidas podem introduzir viés de seleção, publicação e de idioma quando utilizada a literatura que está prontamente acessível ao pesquisador (109). Embora diretrizes rápidas objetivem reduzir o trabalho e o tempo necessário para elaboração do documento, elas devem fornecer a mesma informação de uma diretriz padrão, indicando explicitamente os métodos utilizados e reconhecendo os potenciais vieses introduzidos pela abreviação desses (89,110). ...
Book
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Livro oficial do Ministério da Saúde brasileiro de métodos para elaboração, availação, adaptação e implementação de diretrizes clínicas (clinical guidelines) no Brasil. Livro metodológico de referência para a Conitec. Autoria em ordem alfabética. Detalhes adicionais de contribuição dos autores no anexo X . Esta obra é disponibilizada nos termos da Licença Creative Commons – Atribuição – Não Comercial – Compartilhamento pela mesma licença 4.0 Internacional. É permitida a reprodução parcial ou total desta obra, desde que citada a fonte. A coleção institucional do Ministério da Saúde pode ser acessada, na íntegra, na Biblioteca Virtual em Saúde do Ministério da Saúde: <www.saude.gov.br/bvs>. O conteúdo desta e de outras obras da Editora do Ministério da Saúde pode ser acessado na página: <http://editora.saude.gov.br> A versão atualmente disponível ainda não possui ISBN. Disponível também em: https://www.gov.br/conitec/pt-br/midias/artigos_publicacoes/diretrizes/diretrizes-metodologicas-elaboracao-de-diretrizes-clinicas-2020.pdf
... The research comprised three stages. The first stage involved rapid research reviews of six aspects of financial inclusion in Britain: access to banking services; to credit; to insurance; household savings and assets; demand for and provision of money advice; and levels of financial literacy and capability (Butler et al., 2005). In the second stage, findings from these reviews were discussed by stakeholders in six evidence evaluation forums held across Britain, where participants were engaged in semi-structured group discussions and encouraged to use their expertise to critically appraise the evidence base to identify areas of agreement, disagreement and outstanding knowledge gaps. ...
Article
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The article aims to discuss findings from a knowledge exchange review of financial inclusion in Britain and compare these to key features of financial exclusion evident from European analyses. This paper is based on an innovative knowledge exchange project. Rapid research reviews analysed evidence on financial exclusion in Britain in relation to access to banking services; to credit; to household insurance; personal savings and assets; money advice provision; and financial capability. The findings from these reviews were discussed by stakeholders representing the private, government, community and civil society sectors in a series of evidence review forums. The results of these discussions were summarised and reconsidered at a national knowledge exchange conference. Throughout the project, stakeholders exchange opinions about the state of financial exclusion knowledge through an online discussion forum. The research identified agreement among British stakeholders over several aspects of financial exclusion, in particular continuing problems of access to mainstream banking services for low income customers and a lack of appropriate and affordable credit provision. Areas of controversy included whether banks denied services to lower income customers or were withdrawing from deprived communities, and the necessity for further regulation of mainstream financial services. Comparing these findings to research from other European countries raises questions about how financial inclusion should be defined, and whether existing indicators capture this adequately across contrasting social, institutional and regulatory contexts. The research raises challenges for policy transfer between countries.
... Rapid reviews and rapid evidence assessments seek to be 'Quick but Not Dirty': 'They aim to be rigorous and explicit in method and thus systematic but make concessions to the breadth or depth of the process by limiting particular aspects of the systematic review process'. 45 The methodology identifies several legitimate techniques that may be used to shorten the timescale. These include carefully focusing 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. ...
Article
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The expansion of evidence-based practice across sectors has lead to an increasing variety of review types. However, the diversity of terminology used means that the full potential of these review types may be lost amongst a confusion of indistinct and misapplied terms. The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains. Following scoping searches, an examination was made of the vocabulary associated with the literature of review and synthesis (literary warrant). A simple analytical framework -- Search, AppraisaL, Synthesis and Analysis (SALSA) -- was used to examine the main review types. Fourteen review types and associated methodologies were analysed against the SALSA framework, illustrating the inputs and processes of each review type. A description of the key characteristics is given, together with perceived strengths and weaknesses. A limited number of review types are currently utilized within the health information domain. Few review types possess prescribed and explicit methodologies and many fall short of being mutually exclusive. Notwithstanding such limitations, this typology provides a valuable reference point for those commissioning, conducting, supporting or interpreting reviews, both within health information and the wider health care domain.
Technical Report
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The Policy Evaluation and Research Unit at Manchester Metropolitan University was commissioned to undertake a review of the Grandmentors programme. The review was funded by Nesta and DCMS as part of the Second Half Fund and was completed between June and September 2017. This external review looks at what Grandmentors offers in the current policy and commissioning environment, and how the model could be evolved for the future.
Article
Purpose – The purpose of this paper is to examine the business case for ethnic diversity in the British National Health Service (NHS). It seeks to contextualise issues around diversity within the current political environment, and identify the barriers to diversity in the NHS. The business case has been very strongly argued as justification for introducing both managing diversity and equal opportunity initiatives – here the paper examines the inconsistencies of using that argument, and maintains that the only justification worth presenting is that based on (deontological) moral arguments. Design/methodology/approach – The paper is conceptual in nature exploring the respective cases for diversity using a broad range of the available literature brought together as part of a rapid evidence assessment. It does so in order to make some far‐reaching claims about the future justifications for active diversification of senior management in key public sector institutions. Findings – The distinctions between the business and moral cases are false, in that both have ethical reference points. However, the business case is not only difficult to translate to public sector institutions; there are also evidential problems with its adoption. In light of this the conclusion here is that the moral (deontological) case is the only one that has any long term value for proponents of diversity. Originality/value – The value of this paper is that it examines the confusion that surrounds different cases for advancing diversity as a policy aim and presents a clear delineation of them. It also draws out some of the – perhaps deliberate – blurring of the cases and underlines the huge problems with this all too common approach. Ultimately, it suggests that morality (deontological) arguments have most purchase in public sector organisations.
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