At the beginning of a public health emergency what’s the utility of a conducting a systematic review?
Background: Systematic reviews (SRs) and other research syntheses have established roles in evidence-based decision making, but a public health emergency presents a unique situation that is not necessarily well suited to SRs. To examine the added value of new SRs in the early stages of an emergency, we will use the recent 2022 mpox (formerly monkey pox) public health emergency of international concern as a case study. The mpox outbreak was identified in May 2022 and affected at least 110 countries globally during 2022. Historically, mpox has been contained in endemic areas of Africa, with sporadic short-lived events occurring in non-endemic countries, and was not an infectious disease with a very large evidence base prior to the outbreak.
Objectives: The objective of this work is to evaluate and discuss the utility of conducting SRs at the beginning of a public health emergency when 1) there are SRs available and 2) new data is not available to incorporate.
Methods: Based on mpox response work, SRs published before and in the first 6 months of the outbreak were evaluated for quality and coverage of the knowledge base.
Results: This presentation will discuss what SRs were available on mpox prior to May 2022, their coverage of the evidence base and quality evaluated using a Measurement Tool to Assess systematic Reviews (AMSTAR). This will be contrasted with SRs produced after May 2022 in preprint or print up to December 2022 to describe the quantity, coverage, coverage overlap and quality of SRs. The goal of this evaluation is to reflect on the utility of conducting SRs in the first few months of the mpox outbreak and, more generally, reflect on strategies during an emergent or rapidly evolving situation to add to the knowledge base in a constructive and useful manner.
Conclusions: The result of this analysis ideally fosters discussion from those conducting synthesis research. Strategies for not duplicating efforts and bringing added value to the literature during a public health emergency include making sure the review is needed, that it can be done in a useful timeline and that it will address existing knowledge needs of decision-makers responding to the emergency.