Andrea C. Tricco

Background: Rapid reviews (RRs) have emerged to inform urgent decision-making and do so by simplifying or omitting systematic review methods. A Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for RRs (PRISMA-RR) does not exist. This scoping review represents the first step of a multi-stage process to develop it. In accordance with PRISMA 2020 and in collaboration with key interest-holders, this review aims to identify potential reporting items to promote complete and transparent reporting of RRs.Methods: In June 2024, we posted a scoping review protocol on Open Science Framework and then conducted database searches in MEDLINE, Cochrane Methodology Register, Embase, and Educational Resources Information Center (ERIC). We used the Canada’s Drug Agency Grey Matters tool for grey literature searching in July 2024. Two independent reviewers determined the eligibility of documents for both the title/abstract and full-text levels. After data were extracted by one reviewer and independently verified by a second reviewer, we summarized that information and identified items related to RR reporting. Results: Database and supplemental searches yielded 4,225 citations. A total of 60 papers were included for analysis (32 evaluations of RRs, 28 guidance documents). A subset of the included documents identified poor RR reporting quality. Ten items unique to RR reporting were identified for consideration in subsequent stages of the PRISMA-RR guideline development. From among those items, two topics emerged: ”Differentiating Characteristics of Rapid Reviews” and ”Authorship and Review”.Conclusions: With inadequate RR reporting in the literature, this scoping review identified potential items for consideration in the PRISMA-RR guideline, particularly around characteristics differentiating RRs from systematic reviews and publication ethics conventions, such as reporting an authorship by-line. The forthcoming development of PRISMA-RR will fill an important gap in the methods literature.

Objective: To evaluate inter-rater agreement and usability of the Critical Appraisal Tool for Individual Participant Data Meta-analysis (CAT-IPDMA).Study Design and Setting: In this developmental evaluation, 18 raters in six sets, each comprising two trainees and one expert, independently applied CAT-IPDMA to 30 published IPD meta-analyses. Domain-level concern ratings were analyzed using ordinal-weighted Gwet’s AC2 overall and by domain, with study-level clustered bootstrap 95% confidence intervals. Usability was summarised using completion time, perceived difficulty, confidence, and UMUX-Lite scores.Results: The overall ordinal-weighted Gwet’s inter-rater agreement coefficient (AC2) is 0.40, with a 95% bootstrap CI of 0.299 to 0.503, and the agreement without chance correction was 72.8%. Exact three-rater agreement occurred in 43.9% of study-domain observations. Agreement varied across the domains, with AC2 values ranging from -0.133 to 0.853. Set-specific AC2 estimates ranged between 0.215 and 0.555. The median completion time was 40.0 minutes for trainees and 27.5 minutes for experts. Perceived difficulty was moderate, and confidence levels were generally high. The average usability (UMUX-Lite) scores were 70.8 (SD 19.9) for trainees and 73.6 (SD 16.2) for experts.Conclusion: CAT-IPDMA takes reasonable but manageable time to complete. The inter-rater agreement varied substantially across domains. The study identified areas where clearer applicability rules and domain-rating algorithms are needed before evaluation of the final version of CAT-IPDMA.

Objective: To evaluate the content validity of the critical appraisal tool for individual participant data meta-analyses (CAT IPD-MA) and iteratively refine the content and structure for practical use.,Method: This multi-phase, expert-based content validity study was embedded within the broader CAT-IPDMA development program. We purposively invited 20 experts: e-Delphi panellists who completed both survey rounds and the consensus meeting. Participants completed an online survey rating the relevance and comprehensibility of the signalling questions, grading criteria, and response options on 4-point scales. Primary quantitative outcomes were item-level content validity indices (I-CVIs), calculated as the proportion of experts assigning ratings of 3 or 4, and the average scale-level content validity index (S-CVI/Ave), calculated as the mean I-CVI across items. An I-CVI of at least 0.79 was prespecified as evidence of acceptable item-level content validity, and an S-CVI/Ave of at least 0.90 as evidence of excellent scale-level content validity. Free-text comments informed item revision.,Results: Of 20 invited experts, 13 completed the survey. The S-CVI/Ave was 0.87 for relevance and 0.91 for comprehensibility. All but one of the signalling questions met the prespecified relevance I-CVI criterion. Feedback led to rewording 12 items, splitting complex ones, and adding ”not applicable” to response options. This approach reduced the item pool to a 26-item tool across 14 domains, including 12 critical items for identifying major limitations, with standardized response options, thereby reducing respondent burden while maintaining comprehensive domain coverage. CAT-IPDMA uses domain-level judgments without a global score.,Conclusions: CAT-IPDMA demonstrates acceptable to excellent content validity as a consensus-based tool for IPD-MA quality appraisal. Relevance was supported quantitatively, comprehensibility identified targeted problems, and comprehensiveness was supported primarily by the earlier consensus phase.

Objectives: An evidence synthesis informed the 2023 WHO infection prevention and control (IPC) guideline for Ebola disease (EBOD) and Marburg disease (MARD). Design: A series of rapid reviews addressed 14 key questions (KQs) related to IPC measures for EBOD and MARD across three themes: (1) transmission/exposure, (2) personal protective equipment (PPE) and (3) decontamination/disinfection. Data sources: Databases (Embase, Cochrane Database of Systematic Reviews, CENTRAL, Global Index Medicus) were searched from inception to May 2024, in addition to searches in MEDLINE and bio/medRxiv servers through an artificial intelligence tool (continuous active learning, CAL). Eligibility criteria: Eligible populations included health workers (HWs), staff and patients in healthcare and/or community settings. Interventions included PPE evaluation, hand hygiene/glove decontamination, spraying of HWs, handling of heavily soiled linen, management of the deceased, environmental decontamination, work exclusion and the IPC ring approach. Infection with EBOD or MARD was a primary outcome of interest and secondary outcomes of interest varied by key question. Data extraction and synthesis: Screening, data extraction, quality assessment (Cochrane RoB-2, Risk Of Bias In Non-Randomized Studies - of Interventions (ROBINS-I)) and evaluation of the certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation (GRADE)) were conducted by an independent reviewer with verification. Data and relevant contextual information were narratively synthesised. Results: Following screening of 5540 studies in CAL and 1062 full texts, nine studies were included that addressed four KQs: one related to transmission/exposure (IPC ring approach), two related to PPE (head/neck skin and mucous membranes coverage; order of eye protection and head covering) and one related to disinfection/decontamination (spraying of HWs during PPE doffing). No studies were included for the remaining KQs, but relevant contextual information in reviewed studies was summarised for all KQs. Evidence was judged to be of low or very low certainty using the GRADE framework due to risk of bias, indirectness and imprecision, and substantive conclusions could not be drawn on the effectiveness of the evaluated IPC interventions. Conclusions: While providing the evidence base for the WHO IPC guideline for EBOD and MARD, this series of rapid reviews identified several critical research gaps. PROSPERO registration number: CRD#42022331537.

Objective: Rapid reviews streamline systematic review methods to provide evidence for decision-makers more efficiently. A common methodological trade-off is the restriction of database selection. Therefore, we aimed to determine the proportion of citations retrieved and recall when restricting the database selection in three systematic reviews of interventions for the management of chronic primary low back pain (LBP). We also describe where missed studies were indexed, duplication across databases and the incremental yield of each database.Design and Setting: We used original search files from three systematic reviews of interventions (acupuncture, education, and TENS) conducted to inform the WHO guideline on non-surgical management of chronic primary LBP. Databases searched were CENTRAL, MEDLINE, Embase, CINAHL, and ICTRP. The acupuncture review also included CNKI and WangFang, and the education and TENS reviews included PEDro. Following Cochrane Rapid Review Methods Group recommendations, the restricted search included CENTRAL, MEDLINE and Embase. We report the proportion of citations retrieved compared to the full search, and recall, the proportion of relevant studies in the restricted search compared to the full search. We also calculated incremental yield of each database and cumulative number needed to screen (NNS) (number of cumulative citations/number of cumulative relevant studies).Results: The restricted searches retrieved 54.7% to 86.0% of citations compared to the full search. Recall ranged from 65.4% to 100.0%, missing up to 34.6% of relevant studies. All studies missed in the acupuncture review were indexed in Chinese databases and the study missed in the TENS review was indexed in PEDro. Across reviews, when added to CENTRAL and MEDLINE, Embase, CINAHL and ICTRP had 0% incremental yield while increasing cumulative NNS. Adding CNKI increased screening work (419 citations) in the acupuncture review due to the screening burden but yielded 31% additional studies. PEDro added minimal screening burden and contributed 6.7% incremental yield in the TENS review.Conclusions: Restricting database selection reduces the workload while retrieving most studies, but risks missing relevant studies when topic-specific databases are key contributors. Excluding such databases may introduce selection bias. Inclusion of topic-specific databases should be determined on a case-by-case basis and may be prioritized over databases such as Embase in restricted search strategies.

Background: Online support groups (OSGs) offer a convenient way for patients with cancer and survivors of cancer to obtain information and support. However, not all OSGs are helpful, and in some cases, they may increase distress. Overall, there is a lack of clear evidence on the effects of OSGs, along with how and why they work. Objective: This study examined how, for whom, and in what contexts OSGs work for patients with cancer and survivors of cancer. Methods: A realist review of the evidence on cancer OSGs was conducted (12 databases, inception to February 15, 2025). We followed Pawson’s steps and the RAMESES (Realist and Meta-Narrative Evidence Syntheses: Evolving Standards) quality standards for realist reviews. The Mixed-Methods Appraisal Tool was used to assess the quality of the evidence. Using a realist logic of analysis, we generated a narrative summary of the findings, context-mechanism-outcome configurations, and a program theory (eg, conceptual framework) to explain how cancer OSGs work. Additionally, we developed evidence-based recommendations for optimizing the effectiveness of OSGs. Results: Of 16,659 papers identified, 168 were included. The evidence was organized into 3 categories, 10 concepts, and 57 context-mechanism-outcome configurations. Cancer OSGs can support patients by providing informational, emotional, appraisal, and altruistic support. This can lead to changes in distress, isolation, empowerment, and self-esteem, through negative and positive appraisals as well as coping efforts. These outcomes, however, depend on user attitudes about OSGs (ie, trustworthy, useful, culturally safe, and easy-to-use), how well the OSG fits their needs (ie, health need, sociodemographic or clinical characteristics, and coping style), and perceptions of control (ie, availability, anonymity, privacy, and autonomy). If an OSG was a good fit for a user’s needs, whether they experienced positive outcomes depended on features of the communication technology (ie, modality, response time, and visual social cues), group composition and dynamics (ie, norms, moderation, safety, cohesion, and belonging), and the nature and content of interactions (ie, emotional expression, cognitive processing, and empathetic responses). These factors trigger underlying mechanisms such as feeling understood, accepted, cared for, valued, reassured, informed, and confident, which result in positive outcomes. Conclusions: OSGs can address supportive care needs and improve psychosocial well-being for patients with cancer and survivors of cancer. However, outcomes depend on specific contexts and mechanisms that impact how well OSGs meet patients’ needs. To optimize effectiveness of OSGs, we recommend (1) helping to assess fit and address specific needs; (2) demonstrating trustworthiness; (3) enhancing anonymity and control, and protecting privacy; (4) enhancing ease-of-use; (5) supporting connection and belonging; (6) encouraging activity; (7) enhancing the nature of content shared to boost therapeutic effects; and (8) monitoring and adjusting design and management strategies.