Can Living Systematic Reviews help to combat the world’s greatest health challenges?
1970 saw the first human monkeypox (MPX) case reported in the Democratic Republic of Congo, and since then it has affected several African countries. Regarded as a neglected tropical disease endemic to Western and Central Africa, MPX has now come to surface in May 2022, with cases of MPX spreading across the world, amassing global attention. According to the World Health Organization (WHO) more than 31,000 cases have now been confirmed since the start of the year and 12 people have sadly died as a result of contracting the virus.
In response to MPX’s growing momentum, the White House Office of Science and Technology Policy (OSTP) recently announced a coordinated call to action with science and technology leaders and advisors from across the globe, and the Group of Chief Scientific Advisors of the European Commission, asking scholarly publishers to make all monkeypox-related research and data immediately available to the public. The WHO also recently declared the escalating global MPX outbreak a Public Health Emergency of International Concern (PHEIC).
As we learned during the COVID-19 pandemic the rapid sharing of research results and data is critical in supporting governments around the world to respond to this crisis. Although we are fortunate that the MPX virus has been well studied, and that countermeasures to prevent and treat the disease exist, this is an evolving situation and there is still much to learn. So how can we keep up with the evidence, especially at a time where there is a call for continued research to guide the development of new diagnostics, treatments, and preventive measures for MPX?
One step ahead
Whilst an unprecedented, and certainly impressive, rapid response took place during the COVID-19 outbreak, it can be argued that processes were blurred, there was unnecessary duplication of effort, with a large-scale outpouring of new, and in some cases, repetitive research. Rather than building on evidence, there was the replication of clinical studies, bringing a spotlight to the cracks in the evidence-based approach leading to research waste. This brings to question whether living systematic reviews (LSRs), a systematic review which is continually updated, incorporating relevant new evidence as it becomes available, can be used in MPX-related research to aid evidence producers, decision makers, funders, publishers, and others, to keep up with this rapidly moving field, as well as increase response time and reduce research waste?
Putting it into practice
Living Evidence was first developed by researchers from Cochrane, a group I have worked with as a co-lead for their Living Evidence publishing interest group. They are a leading producer of scientific evidence on health topics and tested by the Australian Stroke Foundation in their national clinical guidelines, to cut the time lag between research being published and implementation of new treatments.
For a LSR to work properly articles need to have a versioning functionality, with all previous versions permanently linked together. While this is a significant challenge using traditional publishing methods, the F1000 versioning system allows us to easily update living systematic reviews and ensure that all earlier versions are linked through a single Digital Object Identifier (DOI).
One of the key problems with living evidence currently is that traditional publishing methods do not facilitate truly living publications. The F1000 publishing model, particularly the versioning system, solves one of the key barriers in allowing multiple versions of an article to be linked together, however, there are still questions around how best to index these publications and what parts of the article should be updated. Additionally, there is a lack of uniformity across publishers in how LSRs are published and updated; something that is being addressed with publication of the LSR PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) extension.
This extension complements the existing PRISMA guidelines, whilst also ensuring that all the aspects of a living method are described and justified along with documenting all changes between versions. These guidelines are being created by an international group of experts in living evidence and authors of the updated PRISMA guidelines: Elie Akl, Matthew Page, Joanne McKenzie, Nicole Skoetz, Venessa Piechotta, Claire Iannizzi, Lara Kahale, and I, as well as input from an invited panel of experts across evidence synthesis. Certainly, now that all academic publishers have been called on to make MPX-related research and data immediately available to the public, there is arguably an even greater need for a streamlined and much more consistent process across the board.
A call for unity
Living evidence forms a pathway for policy makers and clinicians to draw on an evidence base of scientific knowledge that is both rigorous and trustworthy, including the latest developments in science – something previously unavailable. The WHO and the UK’s National Institute for Health and Clinical Excellence (NICE), have endorsed the living evidence approach and are using it for their COVID-19 guidelines.
With the WHO’s quick response to escalating MPX as a PHEIC, we hope to see LSRs employed much more widely to help address this outbreak and, as such, are actively calling for Living Systematic Review submissions (as well as other article types) as part of the launch of a new MPX Collection on F1000Research. The Collection will bring together important research related to any aspect of MPX and ensure this information is readily available for researchers, educators, health officials and the general public. As we learned during the COVID-19 pandemic the rapid sharing of research results and data is critical in supporting governments around the world to respond to this crisis.
The F1000Research MPX Collection is currently running a call for participation and welcomes a range of article types including opinion pieces, living systematic reviews, original research articles and many more. The deadline for submissions is 19th of January 2023. Read more about the Collection here.
About the author:
James Barker is an Associate Publisher at F1000 and has served as the Co-Lead for the publishing interest group of Cochrane’s Living Evidence Network, formerly the Living Systematic Review Network. He has worked at F1000 for over 4 years, starting as an Assistant Editor in 2017 at F1000Research. James has a Bachelors’ degree in Biomedical Sciences and Master of Research in Cancer, having also undertaken lab work. James’ dedication to the field of scientific research has resulted in steps taken towards innovation at F1000. More of his contributions, including using systematic reviews to close the evidence gap, can be found on F1000Research.