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Rapid Review Protocol

What is a rapid review?

A rapid review (or rapid evidence assessment) is a variation of a systematic review that balances time constraints with considerations in bias.

Step 1: Form/refine Question

Consider your research question. Is it focused and well-defined?

After taking into account basic considerations such as the biology and physiology of the problem, its epidemiology, and the unsatisfactory clinical performance and patient outcomes that lead to interest in the topic, Haynes3 suggests the following to further develop a research topic:

  • What is the appropriate stage for evaluation?
  • Can internal validity be achieved?
  • To what extent is external validity achievable?
  • What will your circumstances permit?
  • What can you afford?
  • What is the best balance between "idea" and "feasibility"?

Alternatively, Farrugia4 summarizes two frameworks for refining research questions, FINER and PICOT.

Step 2: Define Parameters

Determine the parameters of your literature search by answering the following questions:

What resources will you search?

Databases commonly searched at VCU include PubMed, CINAHL, Web of Science, and PsycInfo. Embase is another good resource for institutions with access to it. Popular "grey literature" resources include clinicaltrials.gov, NIH RePORTERDissertations and Theses, and professional associations' conference proceedings. Check our research guides for additional resources.

What will be your inclusion/exclusion criteria?

Some criteria to consider include: time period, language, location, age range, animal or human studies, type of published materials (e.g. randomized-control trials, cohort studies, etc.)

What will be your screening protocol?

Things to consider include:

  • How many reviewers will you have and who will they be? (The IOM recommends a team of 2+ reviewers for systematic reviews.)5

  • If you use multiple reviewers, how will disagreements between them be settled (e.g. consensus, third-party)?

The Cochrane Handbook (7.2.3) lists specific steps to take in the screening and selection process that could be adapted for a rapid review.2

How will you appraise the quality of selected studies? What tool/rubric will you use?

  • Many reviews employ a system similar to that developed by the Cochrane Handbook for assessing bias in interventional studies(Section 8.5, Table 8.5a).2

  • Many recent studies also analyze and suggest more efficient and reliable ways to assess the quality of quantitative, qualitative, and mixed methods studies. See supplemental resources.

  • Critical appraisal worksheets may be useful  for a small number of studies. Some examples of these can be found on the Oxford Centre for Evidence-Based Medicine's (CEBM) website, and Duke's EBP research guide. Note whether you decide to modify these worksheets in order to save time; this may create some bias in your conclusions.

Step 3: Identify Biases

As a result of your choices in Step 2, what biases will be introduced into your protocol? Are these biases acceptable given your time constraints?

Step 4: Plan & Execute Search

Plan your search.

  • Consult with a health sciences librarian. Some studies have shown that librarian involvement can improve the quality of reported systematic review and meta-analysis search strategies.9,10
  • Determine the best method for documenting your search (e.g. spreadsheet, etc.). 
  • Select a citation management tool to use. VCU librarians can provide instruction and troubleshooting for Mendeley and Zotero, which are free to the VCU community.

Execute your search and store your citations.

Step 5: Screen & Select

Screen search results based on the criteria defined in Step 2.

A table or worksheet is often used to keep track of the screening and review process. Sample screening worksheets: 1, 2, 3.

Step 6: Quality Appraisal

Apply appraisal tool/rubric selected in Step 2 to identify high quality studies that will be included in your evidence synthesis. The simplest way to track the final quality judgment will vary by tool, e.g. 1, 2.

Evidence summary tables are used to track important characteristics of appraised studies, including the reference, study design, sample size, and quality score. Examples of tables used to present the studies included in a review differ by the aspects listed above as well as other, e.g. 1, 2, 3Consider creating your own review matrix (sample Excel file) to take notes on papers that will be included in your study.

Step 7: Evidence Synthesis

A narrative synthesis of studies that made it through the screening and quality appraisal phases is a simple, efficient way to set the stage for your own work. At a minimum, the synthesis should include:

  • Study problem / purpose
  • Relevance / rationale of the study
    • Why is the research important?
    • Has it been done before?
    • How will the study benefit patients, increase knowledge, or influence policy?
  • Implications for study design / methods
    • What methods are most commonly used in previous studies?
    • What are the most common outcomes analyzed?
    • Is there a significant patient population that is not well - studied?
  • Possible limitations / bias of your review
    • What limitations were present in the existing body of research?
    • What sources of bias could have been introduced in your review of literature?