REH-COVER (Rehabilitation – COVID-19 Evidence-based Response) action: a “rapid” and “living” systematic review methodology
2Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
3Department of Biomedical, Surgical and Dental Sciences, University "La Statale"; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
4Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
5Cochrane Rehabilitation, Milan, Italy
6Department of Biotechnology and Life Sciences, University of Insubria, Varese; Istituti Clinici Scientifici Maugeri IRCCS, Varese, Italy
7Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
Background: Due to the urgent need for rehabilitation by people with COVID-19, Cochrane Rehabilitation merged the concepts of "rapid" and "living" systematic reviews and designed an innovative and dynamic methodological approach for evidence synthesis during health emergencies.
Objectives: This study presents the methodological innovation of “rapid living” systematic reviews and our experience to discuss its strengths and weaknesses.
Methods: The two concepts, “rapid” and “living”, were introduced to keep pace with the rapid and constant growth of evidence, and they can be particularly useful in rapidly evolving research fields. The pandemic brings the two challenges together, i.e. the need for rapid knowledge synthesis as well as the need for constant updates. We applied these two concepts to conduct rapid living systematic reviews on COVID-19 to keep the rehabilitation stakeholders rapidly and constantly updated from March 2020 to February 2022.
Results: Three main editions (March 2020, June 2020 and June 2021) and 13 monthly or bi-monthly updates have been published. Each edition represented an upgrade in methodology due to the growing quality and improved design of current evidence: the first included all study designs, the second excluded expert opinions and papers not reporting patients’ data and the third excluded case reports and case series. Starting from 36327 records overall, a total of 615 papers have finally been included. The most frequent study designs were cross-sectional studies, case reports and case series and cohort studies. Table 1 reports the distribution of included papers according to the study design.
Conclusions: Our methodology, combining the concepts of “rapid” and “living”, can be defined as "a dynamic method of knowledge synthesis that allows for the constant updating of new emerging evidence and refinement of its methodological quality". This method accelerates the conduct of systematic reviews and allows for an adaptation of methodology based on the quality of the evidence. Similarly, it may be helpful when a rapid answer is needed to make informed decisions. The current pandemic has shown that modern medical science has the ability to produce new knowledge at an unexpected rate.
Patient, public and/or healthcare consumer involvement: Not applicable.