iCAHE Rapid Review Team

iCAHE Rapid Reviews provide a targeted, focused and purpose-driven summary of the current research evidence for an industry-defined question. Whilst the iCAHE Rapid Review methodology uses the same principles of systematic searching, critical appraisal and data synthesis as the other forms of Secondary Research Evidence, and as outlined in the PRISMA reporting standards, iCAHE Rapid Reviews are faster and consider only the best available literature to answer the question (highest hierarchy, best quality evidence) using   a more targeted search strategy.

Differentiating Rapid Reviews from other Secondary Research Evidence Reviews

Evidence-based practice (EBP) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients (Sackett et al 1996). It is based on the integration of four sources of evidence: the therapist’s clinical expertise, the patient’s values & preferences, the research evidence and the local context (i.e. the socio-cultural environment in which the service is provided). All four sources of evidence are considered equal in the decision making process (Satterfield et al 2009).  

• Patient (or Consumer) values and preferences refer to the individual patient's predicaments, values, beliefs, rights, and preferences regarding the care they receive.
• Clinical expertise refers to the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice (Sackett et al 1996). 
• Research evidence refers to the best available research evidence relating to the type of question and the specific practice or policy the question is about. This may involve quantitative data (numerical results of a study) or qualitative data (non-numerical observations and patient/consumer input into a study).
• The final source, local context, includes both the environment that the patient, clinician and clinic exist in, and the organisational structures that are in place (i.e.: the health care system, nature of local practice, available resources and any other concerns regarding the localization or contextualization of the evidence (Satterfield et al 2009).  

Secondary Research Evidence Reviews, such as Rapid Reviews, provide a summary of the Best Research Evidence, usually related to the effectiveness of a clinical intervention.

The Rapid Review process:

Figure 1. The iCAHE rapid review process with noted input from the project team, technical team and client (Bold arrows indicate higher levels of interaction) 

Defining the Rapid Review question: iCAHE staff work closely with the client to ensure clear aims and objectives of the Rapid Review, the targeted clinical question to be answered and specific deliverables (including timelines). Relevant questions which inform the Rapid Review include:

• Who is the audience?
• In what format will the Rapid Review report be presented?
• What other deliverables are required, based on the Rapid Review report (consumer summaries, flow charts or if-then statements)?
• Which members of the iCAHE technical team are required for the Rapid Review? (iCAHE has access to a range of allied health, medical and nursing expertise, as well as consumer representatives).
• Are there any key research evidence or evidence sources that the client can provide?

Setting the search strategy: Once the clinical question is finalised a targeted and defensible search strategy is developed by the iCAHE project team, validated by an independent university librarian (with expertise in Secondary Research Evidence Reviews), and confirmed with the client.

• This search strategy includes all relevant search terms and specific databases to be searched, and specific inclusion and exclusion criteria. Due to the nature of a Rapid Review only the health databases considered to be most likely to provide relevant evidence are searched, as dictated by the question.
• Where relevant, date restrictions for searching will be included (i.e. literature published in the last five years).
• If the Rapid Review is to include grey literature sources (usually a specific client request), this needs careful consideration, as this may considerably increase the time needed to conduct the search.
• The iCAHE team will engage the client in validating the included and excluded articles for the Rapid Review.

Critical appraisal: Appraisal of the quality of the included research evidence is undertaken using a formal domain-based critical appraisal tool. All iCAHE staff have extensive experience in the use of a wide range of critical appraisal tools (see list of Critical Appraisal Tools on the Resources section of the iCAHE website [www.unisa.edu.au/cahe]). Depending on the extent of review, and the time available, this appraisal process may include more than one reviewer to enhance the rigour of the appraisal process.

Data Extraction: A custom-designed data extraction template is developed in consultation with the client, relevant to the Rapid Review question(s). All included papers are read in full, and relevant data extracted for synthesis.

Data Synthesis: This synthesis provides a summary of the quantity, hierarchy and quality of the research evidence, and the ’on-balance’ findings relevant to the Rapid Review questions. These findings are discussed with the client prior to production of the report.

Production of the report: The report is generally presented in a 1: 3: 25 page format, unless otherwise indicated.  The one-page presents a summary of objectives and findings relevant for policy briefing purposes.  The three-pages present an executive summary of the review, and the 25 pages report on the methodology, details of the included literature, the literature synthesis and the on-balance findings, and reasons underpinning these. This report is presented in a way that maximises its relevance to, and impact on, the specific target audience.

Limitations of any Secondary Research Evidence Review.

• Relevant to all secondary research evidence reviews, the findings reflect only the currently available literature to the date of literature cut-off. New research published since may supersede the review evidence.
• The findings summarise the current literature, and do not provide new primary evidence.  The generalisability of literature reviews is limited by design constraints in the primary evidence.
• However all secondary research evidence reviews present the research evidence only.  A comprehensive understanding of EBP requires consideration of the therapist’s clinical expertise, the patient’s values & preferences, the research evidence and the local context (i.e. the socio-cultural environment in which the service is provided).

Limitations of a Rapid Review.

• A Rapid Review attempts to collect the best, most current and highest level of scientific research available on the topic.  Due to the targeted nature of the search, the methodological limitations imposed on it and the time restrictions involved, the process is not as comprehensive as that of a comprehensive Systematic Review. 

If you are interested in utilizing the iCAHE Rapid Review team, please feel free to contact us: 

International Centre for Allied Health Evidence
University of South Australia
GPO Box 2471
Adelaide  SA  Australia  5000
Telephone: +61 8 8302 2072
Fax: +61 8 8302 2853
Email: iCAHE@unisa.edu.au