2 week systematic reviews (2weekSR)
What is a 2weekSR?
A 2 week systematic review (2weekSR) is a full systematic review (SR) done to a high methodological standard following all the normal systematic review processes, completed in a vastly shortened time frame. The award-winning 2weekSRs combine the following elements: a team with complementary SR skills, previous SR experience, systematic review automation (SRA) tools, and agile development processes. These factors allow for the completion of an accelerated SR in extremely shortened time frames – generally in 2 weeks.
How the 2weekSR came about
Advancing systematic reviews to the point where they can be completed in two weeks has long been a dream of Paul Glasziou, Director of the Institute for Evidence-Based Healthcare (IEBH). When he mentioned that goal again in late 2018, several members of the IEBH team felt that IEBH’s automation and methodological development programmes were sufficiently advanced to attempt to complete a full systematic review in 2 weeks (2weekSR).
Therefore, a team of four experienced systematic reviewers with complementary skills attempted to complete a 2weekSR in January 2019: an epidemiologist (Anna Mae Scott), an information specialist (Justin Clark) and two clinician-researchers (Chris Del Mar and Paul Glasziou).
A topic was chosen, the team was set loose, and the clock started ticking at 9:30am on 21 January 2019.
The final product was a full systematic review using standard methodology, completed at 12:10pm on Friday, 1 February - 9 working days (11 calendar days) later. After taking a well-earned long weekend off, the team submitted the systematic review for publication on 5 February - 14 calendar days after starting the systematic review.
The results of this methodological race against the clock were written up and published in the British Journal of General Practice (the systematic review itself), and the Journal of Clinical Epidemiology (the processes and methods paper).
The 2weekSR case study
Clark, J., Glasziou, P., Del Mar, C., Bannach-Brown, A., Stehlik, P., & Scott, A. M. (2020). A full systematic review was completed in 2 weeks using automation tools: a case study.J Clin Epidemiol, 121, 81-90.
Abstract Our aim was to describe the process, facilitators, and barriers to completing the first 2-week full SR. We systematically reviewed evidence of the impact of increased fluid intake, on urinary tract infection (UTI) recurrence, in individuals at risk for UTIs. The review was conducted by experienced systematic reviewers with complementary skills (two researcher clinicians, an information specialist, and an epidemiologist), using Systematic Review Automation tools, and blocked off time for the duration of the project. The SR was completed in 61 person-hours (9 workdays; 12 calendar days); accepted version of the manuscript required 71 person-hours. In conclusion, a small and experienced team, using Systematic Review Automation tools, who have protected time to focus solely on the SR can complete a moderately sized SR in 2 weeks.
2weekSR automation tools
2 week systematic reviews are greatly accelerated by the use of systematic review automation tools. All our tools are freely available on the SRA website.
#1: Increased fluid intake to prevent UTIs
Scott, A.M., Clark, J., Del Mar, C. and Glasziou, P., 2020. Increased fluid intake to prevent urinary tract infections: systematic review and meta-analysis. British Journal of General Practice, 70(692), pp.e200-e207.
Clark, J., Glasziou, P., Del Mar, C., Bannach-Brown, A., Stehlik, P. and Scott, A.M., 2020. A full systematic review was completed in 2 weeks using automation tools: a case study. Journal of Clinical Epidemiology, 121, pp.81-90.
Clark, J., Scott, A.M. and Glasziou, P., 2020. Not All Systematic Reviews Can Be Completed in 2 Weeks-But Many Can Be (And Should Be). Journal of Clinical Epidemiology, pp.S0895-4356.
#2: Self-management for men with lower urinary tract symptoms
Albarqouni, L., Sanders, S., Clark, J., Tikkinen, K.A. and Glasziou, P., 2021. Self-management for men with lower urinary tract symptoms: a systematic review and meta-analysis. The Annals of Family Medicine, 19(2), pp.157-167.
#3: Copper plating of commonly touched surfaces to prevent infection
Albarqouni, L., Byambasuren, O., Clark, J., Scott, A.M., Looke, D. and Glasziou, P., 2020. Does Copper treating of commonly touched surfaces reduce healthcare acquired infections? A Systematic Review and meta-analysis. Journal of Hospital Infection
#4: Estimating the extent of true asymptomatic COVID-19
Byambasuren, O., Cardona, M., Bell, K., Clark, J., McLaws, M., and Glasziou, P. 2020. Estimating the extent of true asymptomatic COVID-19 and its potential for community transmission: systematic review and meta-analysis. JAMMI
#5: Seroprevalence of SARS-CoV-2 infections
Byambasuren, O., Dobler, C.C., Bell, K., Rojas, D.P., Clark, J., McLaws, M.L. and Glasziou, P., 2021. Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: systematic review. Plos one, 16(4), p.e0248946.
#6: Downsides of face masks and mitigation strategies
Bakhit, M., Krzyzaniak, N., Scott, A.M, Clark, J., Glasziou, P., Del Mar, C. 2021. Downsides of face masks and possible mitigation strategies: a systematic review and meta-analysis. BMJ Open. 11:e044364.
#7: Head of bed elevation for GERD
Albarqouni, L., Moynihan, R., Clark, J., Scott, A.M., Duggan, A. and Del Mar, C., 2021. Head of bed elevation to relieve gastroesophageal reflux symptoms: a systematic review. BMC family practice, 22(1), pp.1-9.
#8: Methamine hippurate for urinary tract symptoms
Bakhit, M., Krzyzaniak, N., Hilder, J., Clark, J., Scott, A. and Del Mar, C., 2020. Does methenamine hippurate decrease urinary tract symptoms in community adult women: a systematic review and meta-analysis. British Journal of General Practice.
#9: Impact of COVID-19 pandemic on utilisation of healthcare services
Moynihan, R., Sanders, S., Michaleff, Z.A., Scott, A.M., Clark, J., To E.J., Jones M., Kitchener, E., Fox, M., Johannson, M., Lang, E., Duggan, A., Scott, I. and Albarqouni, L., 2021. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021 Mar 16;11(3):e045343
#10: Antibiotic prescribing in telehealth for acute infections
Bakhit, M., Baillie, E., Krzyzaniak, N., van Driel, M., Clark, J., Glasziou, P., & Del Mar, C. (2021). Antibiotic prescribing for acute infections in synchronous telehealth consultations: a systematic review and meta-analysis. BJGP open. https://doi.org/10.3399/BJGPO.2021.0106
#11: Antibiotics vs no treatment for bacteriuria in aged care
Krzyzaniak, N., Forbes, C., Clark, J., Scott, A.M., Del Mar, C., & Bakhit, M. Antibiotics versus no treatment for asymptomatic bacteriuria in aged care residents: a systematic review and meta-analysis. Accepted in the British Journal of General Practice (available online end May 2022).
#12-20: Telehealth 2weekSR
Telehealth provision of primary and allied healthcare was temporarily enabled in Australia during the COVID pandemic. In the first 12 months, over 46 million telehealth care services were delivered to Australians.
In October 2020, the IEBH team was commissioned by the Commonwealth Department of Health to conduct systematic reviews on the safety and effectiveness of the telehealth.
We prepared 9 systematic reviews in 12 weeks (an average of 1 systematic review completed in 1.33 week, i.e., 7 workdays), on the following topics:
- Telehealth vs. face-to-face delivery of care for anxiety disorders: a systematic review and meta-analysis (published, J Telemed Telecare, DOI: 10.1177/1357633X211053738)
- Telehealth vs. face-to-face delivery of care for depression (published, Psychological Medicine, pp. 1 - 9, DOI: 10.1017/S0033291722002331)
- Telehealth vs. face-to-face delivery of care for diabetes
- Telehealth vs. face-to-face delivery of care for insomnia (under review)
- Telehealth vs. face-to-face delivery of care for less common mental health conditions (published, JMIR Mental Health, 9(3), e31780. DOI: 10.2196/31780)
- Telehealth vs. face-to-face delivery of care for musculoskeletal conditions (published, Physical Therapy Reviews, 1-7, DOI: 10.1080/10833196.2023.2195214)
- Telehealth vs. face-to-face delivery of care for pain
- Telehealth vs. face-to-face delivery of care for PTSD (published, Journal of Clinical Psychiatry, 83(4), [21r14143], DOI: 10.4088/JCP.21r14143)
- Telehealth vs. face-to-face delivery of speech pathology care (under review)
2weekSRs on Telehealth informed the decision about permanently implementing telehealth in Australia ($106M investment), increasing healthcare access for 26M Australians, especially in rural/remote areas, and has led to its widespread adoption (see: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/permanent-telehealth-to-strengthen-universal-medicare).