[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
BMC Med. 2019 Jun 11;17(1):107. doi: 10.1186/s12916-019-1338-1.
A rapid research needs appraisal methodology to identify evidence gaps to inform clinical research priorities in response to outbreaks-results from the Lassa fever pilot.
Sigfrid L1, Moore C2, Salam AP2,3, Maayan N4, Hamel C5, Garritty C5, Lutje V6, Buckley B7, Soares-Weiser K8, Marshall R9, Clarke M10, Horby P2.
Author information: 1 Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK. email@example.com. 2 Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK. 3 United Kingdom Public Health Rapid Support Team, London, UK. 4 Cochrane Response, Cochrane, London, UK. 5 Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. 6 Cochrane Infectious Diseases Group, Liverpool School of Tropical Medicine, Liverpool, UK. 7 Department of Surgery, Philippine General Hospital, National University of the Philippines, Manila, Philippines. 8 Editorial & Methods Department, Cochrane Central Executive, Cochrane, London, UK. 9 , London, UK. 10 Evidence Aid, Centre for Public Health, Queen’s University Belfast, Belfast, UK.
Infectious disease epidemics are a constant threat, and while we can strengthen preparedness in advance, inevitably, we will sometimes be caught unaware by novel outbreaks. To address the challenge of rapidly identifying clinical research priorities in those circumstances, we developed and piloted a protocol for carrying out a systematic, rapid research needs appraisal (RRNA) of existing evidence within 5 days in response to outbreaks globally, with the aim to inform clinical research prioritization.
The protocol was derived from rapid review methodologies and optimized through effective use of pre-defined templates and global time zones. It was piloted using a Lassa fever (LF) outbreak scenario. Databases were searched from 1969 to July 2017. Systematic reviewers based in Canada, the UK, and the Philippines screened and extracted data using a systematic review software. The pilot was evaluated through internal analysis and by comparing the research priorities identified from the data, with those identified by an external LF expert panel.
The RRNA pilot was completed within 5 days. To accommodate the high number of articles identified, data extraction was prioritized by study design and year, and the clinical research prioritization done post-day 5. Of 118 potentially eligible articles, 52 met the data extraction criteria, of which 46 were extracted within the 5-day time frame. The RRNA team identified 19 clinical research priorities; the expert panel independently identified 21, of which 11 priorities overlapped. Each method identified a unique set of priorities, showing that combining both methods for clinical research prioritization is more robust than using either method alone.
This pilot study shows that it is feasible to carry out a systematic RRNA within 5 days in response to a (re-) emerging outbreak to identify gaps in existing evidence, as long as sufficient resources are identified, and reviewers are experienced and trained in advance. Use of an online systematic review software and global time zones effectively optimized resources. Another 3 to 5 days are recommended for review of the extracted data and to formulate clinical research priorities. The RRNA can be used for a “Disease X” scenario and should optimally be combined with an expert panel to ensure breadth and depth of coverage of clinical research priorities.
KEYWORDS: Clinical research priorities; Emerging infectious diseases; Lassa fever; Outbreak response; Rapid research needs appraisal methodology
PMID: 31185979 DOI: 10.1186/s12916-019-1338-1
Keywords: Lassa Fever; Infectious Diseases; Pandemic preparedness.