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. 2014 Feb 18;11(2):e1001603.
doi: 10.1371/journal.pmed.1001603. eCollection 2014 Feb.

Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap

Julian H Elliott  1 , Tari Turner  2 , Ornella Clavisi  3 , James Thomas  4 , Julian P T Higgins  5 , Chris Mavergames  6 , Russell L Gruen  7
Affiliations

Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap

Julian H Elliott et al. PLoS Med. .

Abstract

The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem.

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Conflict of interest statement

All authors are contributors to the Cochrane Collaboration. JHE is a Senior Research Fellow at the Australasian Cochrane Centre, which supports the conduct and use of systematic reviews. The views expressed in this paper are JHE's own and not necessarily those of the Australasian Cochrane Centre or the Cochrane Collaboration. TT has an unpaid adjunct position as a Senior Research Fellow at the Australasian Cochrane Centre, which supports the conduct and use of systematic reviews. The views expressed in this paper are TT's own and not necessarily those of the Australasian Cochrane Centre or the Cochrane Collaboration. CM is an Academic Editor for PLOS ONE and is a full-time employee of The Cochrane Collaboration. JHE and RG co-lead the development of a systematic review workflow management tool (Covidence). Covidence has been developed with funding from competitive government grants and is provided as a not-for-profit service to the systematic review community.

Figures

Figure 1
Figure 1. Time from primary study publication to incorporation in systematic review.
Analysis of 792 study reports incorporated into 73 systematic reviews across 28 high priority topics in the field of neurotrauma. Study reports were included in the analysis if they were incorporated into a systematic review relevant to one of the high priority topics and published in the period 2001–2009. Systematic reviews were included in the analysis if they were relevant to one of the high priority topics and published in the period 2001–2012. Bars represent medians and interquartile range.
Figure 2
Figure 2. Current and emerging health knowledge ecosystems.
The current health knowledge ecosystem (inner circle) is characterized by inefficiencies that hamper the flow of knowledge from health practice through primary research, systematic review and guidelines, and finally back to impacts on health practice. The new health knowledge ecosystem that is emerging (outer circle) is characterized by a continuous flow of knowledge between efficient, living components, including the growing importance of learning health care systems, which together with traditional primary research will populate common data repositories. Living evidence services derived from these repositories, supporting living guidance and decision support systems will close a “living” health knowledge loop.
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