It often takes years before practice-changing evidence reaches patients in routine clinical practice. Contributing factors include the prolonged time it takes for guideline organizations to update their recommendations, and lack of supporting tools for shared decision-making. In response, we have created the BMJ RapidRecs project.
Faced with potentially practice-changing evidence, we aim to, within 90 days, create and disseminate trustworthy recommendations, evidence summaries, and consultation decision aids addressing important topics in: 1) a novel and user-friendly single page synopsis format, and 2) digitally structured multi-layered presentation formats on the MagicApp (www.magicapp.org).
We screen new evidence daily through a tailored system, which identifies the most relevant and newsworthy research. After a topic is chosen, we recruit a full guideline panel with no relevant financial and minimal intellectual interests. The panel, including patients, content experts, methodologists, and frontline clinicians finalize the question. A parallel team performs systematic reviews addressing relative effects, baseline risk, and values and preferences, as necessary within 45 days. The panel then considers the evidence and makes recommendations. GRADE and standards from the institute of medicine provide a framework for each step in the process. The recommendation and evidence synopsis, and its supporting systematic reviews, is published in one or more journals.
In the first year, we have completed 6 BMJ RapidRecs (www.bmj.com/rapid-recommendations), with several more planned or in preparation. All supporting evidence is accompanied by interactive infographics, GRADE summary of findings, and decision aids for the clinical encounter.
Multidisciplinary teams can produce trustworthy recommendations, presented in understandable formats that are easily accessible by patients and clinicians, in a very short timeframe. This approach demonstrates potential synergies between evidence synthesis, appraisal and dissemination, within the broader “Evidence Ecosystem”.
To share and discuss our experience in producing rapid recommendations, with a particular focus on the management of conflict of interest, patient partnership, the use of digital authoring and publication platform throughout the process, and how to break silos between actors in the evidence ecosystem.
|Cook, Sophie||Chairman||British Medical Journal||United Kingdom|
|Guerin Philippe||Participant||Infectious Diseases Data Observatory (IDDO) @ University of Oxford||United Kingdom|
|Milevska Neda||Participant||IAPO||United Kingdom|
|Nilay Shah||Participant||Mayo Clinic||USA|
To share and discuss our experience in producing rapid recommendations