Methods for conducting a living evidence profile on mpox: an evidence map of the literature

Session Type
Living syntheses and prospective meta-analyses
Pussegoda K1, Corrin T1, Baumeister A1, Ayache D1, Waddell L1
1Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Canada

Background: The mpox outbreak was declared a public health emergency of international concern on July 23, 2022 by the World Health Organization after outbreaks were identified in several non-endemic countries. Mpox virus is an orthopoxvirus that causes mild to severe disease in humans including a pox rash and lymphadenopathy that can cause severe pain and discomfort. During the outbreak there was an urgent need to have up-to-date evidence on mpox to inform public health decision-making.
Objectives: Develop and maintain a living evidence profile (LEP) on mpox literature during the 2022 outbreak.
Methods: A LEP was prioritized to systematically identify, classify, and synthesize new literature to provide updated evidence on epidemiological parameters including transmissibility, clinical outcomes, and protective immunity on mpox. A comprehensive search in Pubmed, Scopus, Europe PMC, and grey literature sources was conducted twice weekly. Primary evidence on mpox from January 2022 onward were included. Study selection and data extraction were conducted by one reviewer and spot checked by a senior reviewer. Results were synthesized descriptively, and a confidence level was reported for each outcome. Case reports without new information and historical evidence were included in an accessible dataset but not the LEP.
Results: The LEP framework was established based on principles of risk assessment, epidemiological parameters for infectious disease modelling and consultation with experts. Between June 1- December 15, 2022, a continuous cycle of literature searches and data extraction fed into 23 weekly LEPs that were disseminated to global health organizations. As of December 15, 2022 there were 1650 articles on mpox, 680 were primary research studies or surveillance reports on the 2022 outbreak, and 503 were included in the profile. The presentation will highlight key features of the mpox LEP which mapped evidence to 31 different outcomes and topic areas.
Conclusions: This new evidence synthesis framework employed during the 2022 mpox outbreak describes a way to systematically identify and organize emerging evidence to inform what is known and highlight knowledge gaps for decision-making during a public health emergency.
Patient, public and/or healthcare consumer involvement: The LEP contributes to methods that result in comprehensive up-to-date evidence for patients.