Evidence Synthesis Ireland, Cochrane Ireland and the HRB Trials Methodology Research Network have refocused their collective resources on prioritised COVID-19 activities to support healthcare policy and practice decision making in Ireland and beyond. The group, called the Emergency Evidence Response Service, is working in collaboration with the NUI Galway Library and colleagues throughout the University (including the Health Behaviour Change Research Group) and broader research community, and are working quickly and flexibly on prioritised questions from the World Health Organisation (WHO), Cochrane, Campbell UK & Ireland, governments, EPPI-Centre (London), the Centre for Evidence Based Medicine (CEBM, Oxford) and others.
The methodological expertise in the group includes evidence synthesis across qualitative, quantitative, mixed methods and meta-analysis, randomised controlled trials, trial methodology, core outcome set development and outcome reporting, prioritisation, psychology, behaviour science, behaviour change, implementation science, open science, information searching, communication and dissemination.
This work was made possible by support from our funders: the Health Research Board and the Health and Social Care, Research and Development (HSC R&D) Division of the Public Health Agency in Northern Ireland.
EERS members are Claire Beecher, Linda Biesty, Nikita Burke, Dympna Casey, Tom Conway, Yvonne Conway, Hannah Delaney, Declan Devane, Elaine Finucane, Sandra Galvin, Vivienne Hanrahan, Catherine Houghton, Fionnuala Jordan, Ciara Keenan, Chris Noone, Jenny Mc Sharry, Eimear Morrissey, Mike Smalle, Valerie Smith, Elaine Toomey, Fiona Quirke
In August, Evidence Synthesis Ireland was asked by the Health Research Board to provide urgent evidence support to the Department of Health’s Expert Advisory Group on Rapid Testing for COVID-19.
We recruited and placed a Research Fellow, Dr Barbara Whelan (0.8 FTE), who will be providing research support to the Rapid Testing Expert Advisory Group.
We are also supporting a researcher (0.2 FTE) from the Economic and Social Research Institute to work on the following synthesis question:
- What are the perceived impacts of onward transmission associated with common activities
Prof Jon Deeks and Dr Jac Dinnes of the University of Birmingham will provide consultancy to the Rapid Testing Expert Advisory Group on rapid testing and in particular diagnostic test accuracy, as well as mentoring three ESI Fellows. Working with Royal College of Physicians of Ireland leads, we recruited and placed 2 experienced Specialist Registrars in Infectious Diseases and 1 in Microbiology.
The Fellows will be working on:
- A prioritised review for the WHO on impact of testing strategies with WHO
- A Cochrane diagnostic test accuracy review on rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection
- A Cochrane network meta-analysis on pharmacologic treatments for COVID-19 for hospitalized patients with COVID-NMA
We have also commissioned three rapid, living systematic reviews for the Expert Group, which will be carried out by colleagues in Canada.
- What is the effectiveness of different COVID-19 rapid testing strategies and different testing frequencies at detecting infectiousness or reducing transmission?
- What is the risk of COVID-19 transmission associated with different activities or settings and what factors contribute to risk and, what are the consequences of onward transmission
- Effectiveness of training and preparedness on successful implementation of rapid testing programmes.
We placed two additional Specialist Registrars in Infectious Diseases as ESI Fellows on these three reviews. These ESI Fellows will be at the coal-face of evolving evidence and will feed that back to the Expert Group as well as contributing their clinical expertise to an evidence base that will likely inform practices internationally.
Development of a risk assessment profile tool to determine appropriate use of SARS-CoV-2 rapid antigen detection tests for different activities and events in Ireland, since October 2021. Euro Surveill. 2022;27(3):pii=2101202. https://doi.org/10.2807/1560-7917.ES.2022.27.3.2101202.
COVID-19 Living Rapid Review Rapid Antigen Testing, Andrew Beck, Nicole Shaver, Alexandria Bennett, Gabrielle Zitiktye, Niyati Vyas,Barbara Whelan,Rhea O’Regan, Aileen Conway, Becky Skidmore,David Moher and Julian Little. Open Science Framework
Cochrane Ireland is a co-convenor of the Cochrane Rapid Reviews Methods Group. Read more here
Burke et al, COVID-19 Emergency Evidence Response Service: report from Ireland (Dec 2020). Read here
Garritty…Devane…et al, Rapid review methods guidance aids in Cochrane’s quick response to the COVID-19 crisis. Read here
Boutron…Devane.. et al, COVID-NMA: a collaborative COVID-19 living evidence project. Read here
In: Collaborating in response to COVID-19: editorial and methods initiatives across Cochrane Click here for the full report
Biesty et al 2020, Process paper in Systematic Reviews (Nov 2020)
Tricco…, Houghton, Devane et al commentary (June 2020)
- Rapid review methods more challenging during COVID-19: commentary with a focus on 8 knowledge synthesis steps, in the Journal of Clinical Epidemiology
Devane, mini-commentary: Minimising duplicate reports in estimating COVID-19 impact (July 2020)
Haddaway…Keenan et al, Journal of Clinical Epidemiology (July 2020)
Gillies…Keenan, Conway… et al, Strategies to improve retention in randomised trials – Cochrane Library (March 2021)
Houghton et al 2020, Cochrane qualitative rapid review (21 April 2020)
- Full review: Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis
- Cochrane EPOC summary – implementation considerations
- ESI – one page summary and webinar on the rapid QES process
- Cochrane podcast and clinical answers
- Cited on Wikipedia infection prevention and control page
- Lead author Dr Catherine Houghton presented to the World Health Organisation, participating in the expert group meeting on WHO Implementation Guidance to Integrate Noncommunicable Disease Service (Nov 2020)
- Cited in WHO interim guidance: Prevention, identification and management of health worker infection in the context of COVID-19 (30 October 2020)
- Cited in the Royal Academy of Emergency Medicines’ Best Practice Guidelines on Emergency Department Infection Prevention and Control during the Coronavirus Pandemic
- Presented at Cochrane’s Editor in Chief Webinar (June)
- Published article about the review in the Irish Times (Nov 2020) as part of ESI’s Writing for Communication scheme.
Fast-tracked prioritised update of a Cochrane review on PPE (Verbeek et al)
- “Personal protective equipment for preventing highly infectious diseases due to contact with contaminated body fluids in health care staff” here.
- Cochrane summary and ESI one-page summary and an animated podcast with >1800 views
- Blogpost on Evidently Cochrane on the above two reviews, on PPE for healthcare workers
- Featured in in 7 news items, and 6 blog posts
- Cited on Wikipedia pages on infection prevention and control and transmission based precautions.
Series of rapid reviews on PPE for the Centre for Evidence Based Medicine in Oxford
- What is the efficacy of standard face masks compared to respirator masks in preventing COVID-type respiratory illnesses in primary care staff? Mar 24 2020
- What is the evidence that COVID-19 personal protective equipment should include shoe covers? April 7 2020
- What is the efficacy of eye protection equipment in primary care settings? April 3 2020
- What is the performance and impact of disposable and reusable respirators for healthcare workers in the context of COVID-19? May 22 2020
- Extended use or re-use of single-use surgical masks and filtering facepiece respirators: A rapid evidence review. June 3 2020
- including an infographic and preprint
- Classification of aerosol-generating procedures: a rapid systematic review, BMJ Open Respiratory Research (Oct 2020)
- Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review, Infection Control & Hospital Epidemiology (2020).
Curran et al, Transmission characteristics of SARS-CoV-2 variants of concern (collaboration with ESI Fellow) March 2021
Ghosn…Devane…Boutron et al, Cochrane review – Interleukin‐6 blocking agents for treating COVID‐19: a living systematic review (March 2021)
Smith V et al, Cochrane Scoping Review, Care bundles for improving outcomes in patients with COVID‐19 or related conditions in intensive care – a rapid scoping review
- This review adds evidence for 1 of 7 new key clinical questions in the WHO’s COVID-19 Clinical Management interim guidance intended for clinicians caring for COVID-19 patients during all phases of their disease (https://www.who.int/publications/i/item/clinical-management-of-covid-19)
- Lead author (VS) was invited to present to the WHO guideline group (Nov 2020)
Noone et al, Cochrane Rapid Review, Video calls for reducing social isolation and loneliness in older people 21 May 2020
- Cochrane Podcast (June 5th) and Cochrane clinical answers
- Evidence summary by Evidence Aid
- Cited on Wikipedia page on social isolation
- Cited in guidance on important publications on COVID-19 from the European Centre for Disease Control
Rapid review of reviews
- What remotely delivered interventions can reduce social isolation and loneliness among older adults? (Report led by EPPI-Centre, co-author D Casey. Systematic review published on F1000)
Cochrane COVID-19 review of clinical practice guidelines for key questions relating to the care of pregnant women (and their babies) are now available here
- PDF handout of slides and data for each question by each country
Cochrane Special Collection – Coronavirus (COVID-19): remote care through telehealth
- Available in 7 languages
- Addresses using telehealth in conditions including asthma, diabetes, cardiovascular disease, dementia, reproductive health, and skin cancer.
- Includes reviews of using telehealth to provide carer and parent support as well as empowering patient self-management
- Participating in the Steering Group and in mapping of a living mapping of studies of COVID-19 (@COVIDNMA).
- Contains living systematic reviews on pharmacological and non-pharmacological treatments, preventive treatments and rehabilitation
- The WHO are now using https://covid-nma.com/as a primary source of evidence on treatments for the prevention and treatment of COVID-19
- You can filter studies by type of pharmacological treatment, registration date, study aim, severity scale and an interactive map of clinical trials per country.
- Paper published in the Annals of Internal Medicine: The COVID-NMA Project: Building an Evidence Ecosystem for the COVID-19 Pandemic
- Protocols in the Cochrane Database of Systematic Reviews 1) Interventions for the prevention and treatment of COVID‐19: a living mapping of research and living network meta‐analysis and 2) Interventions for the treatment of COVID‐19: a living network meta‐analysis
- Cochrane Ireland, France, Austria, Germany and IQWiG, calling for transparency of COVID19 studies, issued an open letter to the European Medicines Agency to make clinical data from trials of COVID-19 medicines and vaccines available at the time of marketing authorisation.
- Collaborating on Meta-evidence Map for COVID19
- iHealthFacts.ie is a platform where the public can submit health claims and our team work to answer the claim by searching for and assessing the available evidence.
- Read HRB Open Letter by Zaki et al on Battling the COVID-19 infodemic in an Irish context: the role of iHealthFacts (Nov 2020)
- Prioritised health claims are assessed with an established process by searching for high-quality evidence to support or refute the claim. The prepared responses are reviewed by a team of Evidence Advisors and by a panel of Public and Patient Advisors.
- Featured in 2 blog posts including Evidently Cochrane blog on how to know what health advice to believe.
- Blogpost by E Finucane on Evidently Cochrane: Personal experiences or anecdotes (stories) are an unreliable basis for assessing the effects of most treatments (Sept 2020)
- Presented at Digital Health NOW! Conference on 23 Nov 2020 (iHealthFacts.ie: separating facts from fiction, Devane, Finucane)
- >1000 followers on social media
- 34 claims ‘fact checked’ to date
- Cited in HRB Open Letter by Murphy et al as an example of PPI during COVID-19 in Ireland.
- The team are now accepting non-COVID health claims for fact-checking (such as, do dock leaves relieve nettle stings?)
- Follow iHealthFacts on Twitter and Facebook
- HRB Trust and Truth in Health Research conference
- Watch back
- Trials in a Pandemic – special symposium
- 4 sessions with 1,600+ registrations
- 10 international speakers, including World Health Organisation
- 23 countries
- Three special COVID-19 and evidence synthesis webinars, to > 700 attendees to date
- Two COVID-related summer studentships awarded
- Publication: Differences in levels of stress, social support, health behaviours, and stress-reduction strategies for women pregnant before and during the COVID-19 pandemic, and based on phases of pandemic restrictions, in Ireland
- Protocol: Investigating and evaluating evidence of the behavioural determinants of adherence to social distancing measures – A protocol for a scoping review of COVID-19 research
- Eight volunteers with Evidence Aid, an international humanitarian organisation, who contributed to a large effort toward producing and translating over evidence summaries.
- We are part of a global network of over 75 researchers co-ordinating evidence synthesis called COVID-END which includes a guide to COVID-19 evidence sources. Also we are members of the International Cochrane COVID-19 Executive Response Team and the Evidence Collaborative for COVID-19 network with the WHO.
COVID-NMA systematic reviews (led by Prof Devane, with F Quirke et al)