Creation and evolution of a Rapid Evidence Service to support evidence-informed public health decision making for COVID-19

Background: Public health decision makers need to be able to easily access evidence in order to apply research to policy and programming decisions. This is of the utmost importance in times of crises when resources become additionally strained, but decisions still need to be made quickly. As COVID-19 pandemic evolved, decisions were also made based on rapidly evolving evidence, of varying quality. In response to this challenge, we developed a Rapid Evidence Service, building on internationally accepted rapid review methodologies, to synthesize the best available evidence on priority COVID-19 public health questions for local, regional and national public health decision makers.

Description: Our process involves: framing prioritized topics received from public health decision makers into searchable questions; developing and conducting a comprehensive search; rapid screening for relevance and minimizing duplication of efforts; critically appraising relevant evidence using validated tools; summarizing key findings from individual studies; GRADEing the evidence; and synthesizing the findings into a final report that includes an overall summary and key messages along with the certainty of the findings, and an overview of remaining knowledge gaps. Our team includes members with specialized expertise in each of these areas and we collaborate with content-specific experts, as needed. We complete and disseminate most rapid reviews within one to two weeks. We have improved the efficiency of our process by using collaborative systematic review technologies and building upon already completed syntheses where available.

Conclusion: We have conducted more than 50 rapid review or review updates in 9 months. We continue to address new priority questions and update some of our completed reviews, as new evidence emerges. Our process has already evolved to ensure feasibility, accuracy, and efficiency as the pandemic and its evidence landscape changes. While we are planning a formal evaluation of our process and its impact, preliminary feedback has shown that this service is helpful, timely, and informative. Our process is one real-world example of how review-level evidence can be mobilized – rapidly, reliably, and needs-driven – during such unprecedented times.