Special article
Rapid reviews for evidence synthesis
Revisiones rápidas para la síntesis de la evidencia
Ferrán Catalá-Lópeza,b,
, Adrienne Stevensb,c, Chantelle Garrittyb,c, Brian Huttonb,d
Corresponding author
a Departamento de Medicina, Universidad de Valencia/Instituto de Investigación Sanitaria INCLIVA, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain
b Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
c Translational Research in Biomedicine (TRIBE) Program, School of Medicine, University of Split, Split, Croatia
d School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Algorithm does not apply to subjects vaccinated due to false positive TST. IGRA: interferon-gamma release assays; TST: tuberculin skin test; XR: X-ray; TNF: tumor necrosis factor. *TST and IGRA must be performed simultaneously or within 72<span class="elsevierStyleHsp" style=""></span>h. TST is considered positive if induration<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mm. <span class="elsevierStyleItalic">Source</span>: Rahier et al.,<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">3</span></a> Ries et al.<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">22</span></a> and Stagg et al.<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">23</span></a></p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Enrique Rodríguez de Santiago, Agustín Albillos Martínez, Antonio López-Sanromán" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Enrique" "apellidos" => "Rodríguez de Santiago" ] 1 => array:2 [ "nombre" => "Agustín" "apellidos" => "Albillos Martínez" ] 2 => array:2 [ "nombre" => "Antonio" "apellidos" => "López-Sanromán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775317300659" "doi" => "10.1016/j.medcli.2016.12.041" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775317300659?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617302784?idApp=UINPBA00004N" "url" => "/23870206/0000014800000009/v2_201706121018/S2387020617302784/v2_201706121018/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>" "titulo" => "Rapid reviews for evidence synthesis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "424" "paginaFinal" => "428" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ferrán Catalá-López, Adrienne Stevens, Chantelle Garritty, Brian Hutton" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ferrán" "apellidos" => "Catalá-López" "email" => array:1 [ 0 => "ferran_catala@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Adrienne" "apellidos" => "Stevens" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Chantelle" "apellidos" => "Garritty" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Brian" "apellidos" => "Hutton" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Medicina, Universidad de Valencia/Instituto de Investigación Sanitaria INCLIVA, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Translational Research in Biomedicine (TRIBE) Program, School of Medicine, University of Split, Split, Croatia" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Revisiones rápidas para la síntesis de la evidencia" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Decision-making in clinical practice and health care, such as requesting a diagnostic test or treatment, should be supported by the best available evidence. For this purpose, it is generally recommended that the information of all available studies on a particular question be taken into account, rather than considering only the results of a single study.<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1–4</span></a> Evidence synthesis from systematic reviews and meta-analysis uses explicit and rigorous methods to identify, select, collect, critically evaluate and synthesize the results of all existing studies. This facilitates the correct understanding of the results of individual studies in the context of all available evidence. It also contributes to knowledge transfer by bridging the gap between research and clinical practice.<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1–4</span></a> However, planning and preparing a comprehensive and transparent systematic review reporting decision-making involves time and resources not always available. For example, it is estimated that a quality systematic review performed by an experienced team may involve over a thousand hours of work (interval 216–2518<span class="elsevierStyleHsp" style=""></span>h) distributed over at least 1–2 years.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">5–8</span></a> On many occasions, clinical and health decisions must be made quickly to respond immediately to the requirements of professionals, managers, planners and patients. With the proliferation of new interventions, services and health technologies in increasingly complex healthcare contexts, the need for independent, continuous and rapid assessments that provide information for objective, rational and transparent decision-making is a reality. In recent years evidence-based synthesis programs have been proposed in addition to traditional systematic reviews, some of which may be framed within rapid response assessment programs<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8–14</span></a> to report the decision-making.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In this special article, the concept of “rapid review” has been introduced, showing its differences versus narrative reviews and systematic reviews, and its importance is discussed through some published examples.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Rapid review</span><p id="par0015" class="elsevierStylePara elsevierViewall">A rapid review<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">7–9</span></a> can be defined as a review of the scientific literature using simplified and rapid methods compared to a traditional systematic review. In the Anglo-Saxon context, where rapid reviews are routinely being used,<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">15–20</span></a> rapid reviews have also been described as rapid evidence assessment, rapid synthesis, rapid health technology assessment, and rapid evidence summary, among others.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Planning and preparing a rapid review may be conditioned by a number of decision-making factors, including a health or clinical emergency, an immediate request to implement or adopt a new technology, procedure or service, and the limited time and resources that prevents a more thorough assessment. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the differences between narrative, rapid and systematic reviews.<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">8,14</span></a> Unlike the narrative reviews, in systematic reviews we use the scientific method to search for potentially relevant studies together with explicit and reproducible criteria, fixed in advance in the selection. In contrast to systematic reviews, rapid reviews often omit or simplify stages to draft a rapid synthesis (e.g., limiting information sources and searches, limiting language and date of publication, not assessing the quality of primary studies, not performing meta-analysis). According to the Cochrane manual,<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">21</span></a> in a systematic review all stages, including screening of studies (titles and abstracts; full text), data extraction and quality assessment (biases) of information should be typically carried out by 2 evaluators independently. In this regard, in rapid reviews, the stages of screening and selection of studies, and the data extraction are often performed by a single evaluator or reviewer (but not always). Some of these situations may make it possible to simplify and accelerate the synthesis of knowledge on a particular subject. However, it must also be considered that errors and potential biases can be added into the evaluation (e.g., omission of studies, errors in data extraction, publication and language biases, etc.).<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">7</span></a> The evidence generated by rapid reviews may be considered to be exploratory in nature, generally aimed at reporting a decision, rather than responding more specific responses such as it happens with more comprehensive and thorough systematic reviews.<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">1,3</span></a> Therefore, it should be a priority that the potential user (or promoter) of the evaluation understand, value and discuss these issues with the research team, when defining the question of interest and the methods (and the completeness of the analyses) to be applied considering the period of time available.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Some examples of rapid reviews</span><p id="par0025" class="elsevierStylePara elsevierViewall">The 2 examples of rapid reviews<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">19,20</span></a> shown below were developed by the Knowledge Synthesis Group of the Ottawa Hospital Health Research Institute to report decision making. In the first review, the researchers tried to respond to the requirements of the center professionals and management team to ensure the effective and efficient use of the hospital emergency services through a short-stay unit.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> In the second review, information was used to respond to the highest level of decision-making (international agencies, ministries of health, etc.) regarding the recommendations on personal protective equipment in the standards of practice in cases of suspected infection by Ebola virus.<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a> In both cases, the researchers performed the rapid reviews in less than 2 months.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In 2011, the management team of the Ottawa Hospital, a public university hospital with over 1100 beds located in the Ontario region (Canada), suggested the idea of introducing short-stay units as an alternative hospitalization strategy facing the organizational challenge of the overloaded hospital emergency services. In this context, a rapid review on the effectiveness and safety of short-stay units was requested to report decision-making<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). To this purpose, the research team defined the question of interest, and provided the methods and documents that would be delivered within the established time frame (4 weeks). We searched electronic databases and sources of gray literature. The eligibility criteria used included only papers published in English available in electronic full-text format. Researchers limited their study selection to published systematic reviews (given the heterogeneity of primary studies and the limited time available to collect information and understand the complexity of the evidence). They excluded papers published prior to year 2000 prioritizing the most recent evidence. The selection of papers was carried out by 2 evaluators. However, the extraction of information, quality evaluation and narrative synthesis were carried out by a single evaluator. The quality of the included systematic reviews was evaluated using the Assessing the Methodological Quality of Systematic Reviews – AMSTAR-tool.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> Totally, 4 published systematic reviews were included. Evidence from a systematic review (12 studies) of moderate quality indicated that short-stay units can lead to better outcomes (patient satisfaction, reduced stay, etc.) and improve efficiency in Emergency services. However, this systematic review was published over a decade ago. Therefore, the recommendation was to carry out a new comprehensive, rigorous and updated systematic review on the subject. Similarly, the researchers found that most of the comparative evaluations of short-stay units used “before and after” type designs, which have limitations such as confusion with natural evolution or the effects of any other (hidden) intervention, and the lack of masked assessment. The generalization of results was limited by the specific approach of the units evaluated (e.g., Cardiology, Pneumology). For this reason, and given the paucity of quality clinical trials, the researchers recommended caution in interpreting the findings. Evidence from the rapid review was positively responded by the hospital management team and was used to report the discussion on the implementation of a short-stay unit. It also helped strengthen partnerships between researchers and the management team, which has led to further research on this issue. Specifically, this rapid review was used as the basis for requesting for funding for a systematic review project that was successfully obtained by the team of researchers and other collaborators.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a> The authors of the systematic review concluded that there is insufficient evidence to draw conclusions about the effectiveness and safety of short-stay units compared to hospital care.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">23</span></a> Therefore, the results of the systematic review support the idea that the authors of the rapid review considered this as a cautious conclusion until the results of a consistent systematic review were available.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">A rapid review performed in 7 weeks was issued in October 2015 to report on the development of the Rapid Advice Guideline on Personal Protective Equipment in the context of the filovirus outbreak of Ebola in West Africa, with special attention to the professionals directly responsible for patients with Ebola or Marburg filovirus disease<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Based on a research protocol developed in July 2014, search was performed in electronic databases and gray literature sources. The eligibility criteria used initially included comparative studies on Ebola and Marburg disease reported in English or French, but subsequently the criteria were expanded for studies on further viral hemorrhagic fevers and non-comparative designs due to the low number of studies. In this review, screening of title and abstract as well as the full text of the relevant articles were evaluated twice (2 people to exclude studies). However, the information was drawn from the studies by a single evaluator, and a second evaluator checked the information in just over half (57%) of the studies. The authors of the studies were not contacted to obtain any additional information due to the lack of time. The quality of the evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation – GRADE – system.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">24</span></a> We identified 30 noncomparative observational studies (8 related to Ebola virus disease) and 27 provided data on viral transmission. Due to the nature and heterogeneity of the included studies, no meta-analysis of the results was performed. Based on low-quality evidence, it was concluded that the presentation of the protective equipment, and infection prevention and control protocols was deficient, which prevented from drawing conclusions about the comparative effectiveness of the various types of personal protection equipment (“absence of evidence” should not be understood as “evidence of absence”). In the rapid review, it was also identified the urgent need for further research that would improve the available evidence on the comparative effectiveness of the protective equipment currently used. This example demonstrates how a rapid review can be incorporated into a guideline, identify the need to improve available evidence and be useful to report urgent public health decision-making.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">25</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Final considerations</span><p id="par0040" class="elsevierStylePara elsevierViewall">An important advantage of rapid reviews is their time of development and, therefore, their ability to guide and assist timely decision making. However, it should also be recognized that in some situations the rapidity of the review may be limited. Often, to complete a review quickly, simplifying the stages of a traditional systematic review is required, which may result in potential errors and/or biases.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">7,8,14</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">There are differences between the development of a standard systematic review and a rapid review. However, the basic principles of systematic reviews also apply to rapid reviews, which would include the application of transparent processes, the use of explicit methods and the reduction of biases. Systematic reviews and meta-analysis play an important role in the planning, design and development of biomedical research.<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">26,27</span></a> In fact, it has been suggested that all researchers should begin their research training by developing at least one systematic review.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a> Perhaps a first step in this direction would be for future undergraduate and graduate students to begin with the methodology of evidence synthesis through rapid reviews. The best qualification of future generations (authors, reviewers and editors) might help increase the value and reduce the potential waste occurring in preparing reviews with little methodological accuracy.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Currently, multiple and varied methodologies have been applied for preparing rapid reviews.<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">29,30</span></a> However, the level of detail in the description of the methods and results of the reviews should be improved.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">7,13,29,30</span></a> Rapidness should not compromise the validity (or transparency) of the methods and results reported in a rapid review. Rapid reviews that do not use explicit or structured methods run the risk of becoming narrative reviews or opinion articles. In situations where key aspects of the methods and results of the rapid review are omitted due to lack of report, any assessment of the validity of the review is seriously hampered. Published rapid reviews should adhere to the guidelines for developing and submitting reviews. Work is currently being performed on initiatives that would include extensions of the current recommendations to cover more specifically aspects and particularities of rapid reviews. Specifically, an extension of the <span class="elsevierStyleItalic">Preferred Reporting Items for Systematic Reviews and Meta-Analyses</span> (PRISMA) for rapid reviews (PRISMA-RR) is being conducted.<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">31</span></a> In addition, a new Cochrane Rapid Review Methods Group<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a> has recently been established, aimed at having an international leadership role in guiding the development of rapid reviews. It is expected that these initiatives will contribute to improving the methods and reporting future rapid reviews, including also those evidence-based programs using analogous terminologies (e.g. rapid assessments of health technologies, etc.).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Funding</span><p id="par0055" class="elsevierStylePara elsevierViewall">FCL has been granted by the Generalitat Valenciana (PROMETEOII/2015/021). BH has received funding from the Canadian Institutes of Health Research (New Investigator Award, Canadian Institutes of Health Research/Drug Safety and Effectiveness Network).</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conflict of interests</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors report no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Rapid review" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Some examples of rapid reviews" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Final considerations" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interests" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-11-30" "fechaAceptado" => "2016-12-24" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Catalá-López F, Stevens A, Garritty C, Hutton B. Revisiones rápidas para la síntesis de la evidencia. Med Clin (Barc). 2017;148:424–428.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Feature \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Narrative review \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Rapid review \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Systematic review \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Period of time (approximately) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Indeterminate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 weeks to 6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 months to 2–3 years \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question of interest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-specific, non-structured \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Specific (although it may be extensive), structured \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Specific (on a well delimited clinical question), structured \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sources and searches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-detailed, non-systematic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">They may be limited, non-comprehensive, although explicit sources and strategies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Structured, comprehensive, explicit sources and strategies \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Selection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-detailed, non-reproducible \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Based on explicit criteria, uniformly applied \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Based on explicit criteria, uniformly applied \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Evaluation of quality and information bias \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Absent \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Structured, it can include critical assessment (from previous systematic reviews, sometimes from primary studies) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Structured, rigorous, critical appraisal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Synthesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Descriptive, qualitative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Descriptive, qualitative (rarely quantitative with meta-analysis when appropriate and time/resources allow) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Descriptive, qualitative and quantitative (usually includes meta-analysis when appropriate) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Inferences \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Generally based on opinion (bias), limited, cautious interpretation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Sometimes evidence-based, limited, cautious interpretation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Generally evidence-based \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1438601.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Differences between narrative, rapid and systematic reviews.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Component \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristics \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Requirement (potential user) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Overloaded hospital emergency services (management team and professionals) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question of interest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">What is the effectiveness and safety of short-stay units? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="5" align="left" valign="top">Methods</td><td class="td" title="table-entry " align="left" valign="top">Define inclusion/exclusion criteria (for example, inclusion of systematic reviews published in English available in full-text electronic format; exclusion of papers published before year 2000) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Define and conduct searches of the medical literature (by an expert documentalist) in Medline, the Cochrane Library, Embase and the Center for Reviews and Dissemination) and gray literature sources (websites of scientific societies and assessment of health technologies) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Screen and select the previous systematic reviews (by two researchers, one expert in methodology and one clinical expert in hospital emergencies) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Data extraction (by a single researcher) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Evaluate the quality of previous systematic reviews (by a single researcher, using the AMSTAR tool) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Results \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Synthesize the results (narrative synthesis by a single researcher) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dissemination \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Prepare the report of the rapid review and disseminate between the management team and health professionals (available through the institutional website: <span class="elsevierStyleInterRef" id="intr0005" href="http://www.ohri.ca/kta/docs/KTA-ED-SSU-Evidence-Summary.pdf">http://www.ohri.ca/kta/docs/KTA-ED-SSU-Evidence-Summary.pdf</span>) [consulted Oct 2016]<br>Publication of scientific article in medical journals<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">19</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1438602.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Example of rapid review on the effectiveness and safety of short-stay units.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Component \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristics \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Requirement (potential user) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outbreak and epidemic due to filovirus disease in West Africa, with special attention on Ebola or Marburg virus infection. Situation of international health emergency (international agencies, ministries of health, health professionals) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question of interest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">What is the effectiveness of protective equipment for professionals/caregivers to prevent from Ebola virus transmission? \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="5" align="left" valign="top">Methods</td><td class="td" title="table-entry " align="left" valign="top">Define inclusion/exclusion criteria (for example, inclusion of comparative studies on protective equipment in Ebola and/or Marburg disease reported in English or French, although the criteria were later expanded for studies on other viral hemorrhagic fevers and non-comparative designs due to the lack of studies) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Define and conduct medical literature searches (by an expert documentalist) in Medline, the Cochrane Library, Embase and African Index Medicus and gray literature sources (ProQuest Dissertation and Theses Databases, Google, ClinicalTrials.gov and the international registry of WHO clinical trials) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Screen and select the identified studies (by a single researcher, although reviewed by a second researcher) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Data extraction (by a single researcher, although 57% of the information reviewed by a second researcher) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Evaluate the quality of evidence (by a single researcher using the GRADE tool, although it does not assess the risk of bias in single studies, as there are no validated tools for non-comparative studies) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Results \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Synthesize the results (narrative synthesis not including meta-analysis) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dissemination \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Prepare the rapid review report used as a guideline for the discussions on providing the recommendations by the WHO: <span class="elsevierStyleItalic">Personal protective equipment in the context of filovirus disease outbreak response</span>. WHO/EVD/Guidance/PPE/14.1. Geneva, Switzerland: World Health Organization; 2014<br>Publication of scientific article in medical journals<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1438603.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Example of a rapid review on the effectiveness of protective equipment for the prevention of Ebola virus transmission.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0165" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Group PRISMA" "etal" => false "autores" => array:4 [ 0 => "D. 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