Cochrane Ireland contributed to COVID-19 by publishing a rapid scoping reviews about care bundles in the intensive care unit (ICU). This review, led by Prof Valerie Smith, was commissioned by the World Health Organisation to inform their guidance. The review serves as an exemplar for how similar research could be published by Cochrane beyond the pandemic.
Cochrane does not ordinarily publish scoping reviews, which differ from systematic reviews in important ways. Rather than summarise the results of studies to assess the effect of an intervention or accuracy of a diagnostic test, the purpose of a scoping review is to identify the amount and type of evidence relating to a given topic. Scoping reviews can play an important role for researchers and decision makers by mapping and characterizing an evidence base to highlight gaps or inform the design of a further systematic review.
Scoping reviews follow many of the same steps of a systematic review including pre-specification of methods, and a systematic approach to identify, sift and present the evidence. They generally have a broader scope than a systematic review and, given that the objective is not to assess effectiveness or safety, there is usually no critical appraisal of studies, synthesis of their outcome data, or application of established GRADE methods.
The reviews followed a set of interim recommendations set by the Cochrane Editorial and Methods Department, which were based on existing conduct and reporting standards and guidance. Areas for development have been highlighted that would be needed to ensure quality and consistency on a wider scale, but the reviews serve as an important proof of concept that we hope to build upon in the future to continue meeting the diverse needs of stakeholders.
Declan Devane, Director of Cochrane Irelandand one of the authors of the ICU care bundles scoping review commented “I think it critical that Cochrane respond to the evidence synthesis needs of health decision makers. Like much of the recent COVID-19 evidence response, this scoping review was only possible in the time available because of the commitment of a team of clinicians and methodologists who were supported flexibly and iteratively by Cochrane. Processes were adapted and flexed to meet commissioners needs resulting in a good experience for all concerned. The learning from our experience will help inform future scoping review processes. I believe firmly that the relevance and value of Cochrane will depend on its ability to respond innovatively, and promptly, to decision-maker needs. This is another example that shows we can.”