Rapid Reviews: The Search for "Best Evidence"
The search for the best available evidence with which to inform practice underpins the purpose of many reviews of the literature. This is also the root of much frustration, when after hours of searching, the ‘best evidence’ is unclear. The traditional assumption that the higher the hierarchy of the research design, the better quality the study has been disproven many times. There are as many poorly designed and executed systematic reviews and randomized controlled trials, as there are well conducted, thoughtful, and informative case studies. In allied health research, there are usually constraints on the conduct of experimental studies in terms of blinding patients and therapists, selecting a sufficiently sized sample, and understanding the impact of multiple interventions. These methodological constraints can thus hamper the production of "best evidence."
Usually the final decision about what constitutes "best evidence" rests with the systematic reviewer, and thus is essentially a qualitative response to questions raised during a technical literature search. The subjective assessment of research quality, research findings linked to the review question, and the determination of the value of the findings in terms of the purpose of the review, is opening up as a new form of research in itself!
Rapid reviews are one approach used to identify and synthesize the best available research and provide an evidence-platform to guide decisions about interventions, diagnostic processes, and application of technologies. They are also termed "rapid assessment reports” or "technotes” or "technology overview.”[1,2] Rapid reviews are limited literature reviews directed to specific health-related questions. They are unlike comprehensive systematic reviews, in that they focus on identifying the highest level of evidence which will provide an answer to the review question. Rapid reviews are scientific documents produced within a short span of time to address a specific question which is usually raised by policy-makers, or service funders. The search approach for rapid reviews focuses on identifying satisfactory quality evidence from a focused and comprehensive literature search of the standard health-related databases. Rapid reviews are designed to give a timely and a quick response, keeping time and resource restraints in mind.
A key to completing Rapid Reviews is the use of expert opinion, which is is sought where needed, to help in the interpretation of the literature in light of the questions which underpinned the purpose of the review. The subjective assessment processes of determining what is ‘best evidence’ are addressed in the methodology of the Rapid Review. Thus The Rapid Review offers a way of exploring the subjectivity of determining "best evidence," and ensuring transparency of decisions.
References
- Hailey, D., Corabian, P., Harstall, C. & Schneider, W. 2000, "The use and impact of rapid health technology assessments", International journal of technology assessment in health care, vol. 16, no. 2, pp. 651-656.
- Maddern, G., Boult, M., Ahern, E. & Babidge, W. 2008, "ASERNIPS - International trend setting", ANZ journal of surgery, vol. 78, pp. 853-858.
Recommended Citation
Grimmer-Somers K. Rapid Reviews: The Search for "Best Evidence". The Internet Journal of Allied Health Sciences and Practice. 2009 Jan 01;7(1), Article 3.
