Evidence Synthesis Ireland

COVID 19

Providing evidence for practice and policy

During the pandemic, Evidence Synthesis Ireland, Cochrane Ireland and the HRB Trials Methodology Research Network refocused their collective resources on prioritised activities to support healthcare policy and practice decision-making for COVID-19 in Ireland and beyond. The group, called the Emergency Evidence Response Service, worked in collaboration with the University of Galway Library and colleagues throughout the University and broader research community. We worked 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 included 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: 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 2021, 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 placed a Research Fellow, Dr Barbara Whelan, who provided research support to the Rapid Testing Expert Advisory Group.

We supported a researcher 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 were available to provide consultancy to the Rapid Testing Expert Advisory Group in diagnostic test accuracy, and mentored three ESI Fellows. Working with Royal College of Physicians of Ireland leads, we placed 6 Specialist Registrars as ESI Fellows on reviews. These ESI Fellows were at the coal-face of evolving evidence and fed that into the Expert Group, and contributed their clinical expertise to an evidence base that has informed practices internationally, including that of the WHO and Canadian government.

  • Cochrane diagnostic test accuracy review on rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection
  • Cochrane network meta-analysis on pharmacologic treatments for COVID-19 for hospitalized patients with COVID-NMA
 

We commissioned three rapid, living systematic reviews for the Expert Group, completed 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.

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

Interim Report of the Expert Advisory Group on Rapid Testing (RTEAG) 21 Oct 2021

Performance of different rapid antigen testing strategies for SARS-CoV-2: A living rapid review. Eur J Clin Invest. 2023 Jul 9:e14058. doi: 10.1111/eci.14058. Shaver N, Bennett A, Beck A, Vyas N, Zitiktye G, Lam E, Whelan B, O’Regan R, Conway A, Skidmore B, Moher D, Little J. 

Cochrane Ireland is a co-convenor of the Cochrane Rapid Reviews Methods Group. Read more here

COVID-19 Emergency Evidence Response Service: report from Ireland (Burke et al, Dec 2020). Read here

Rapid review methods guidance aids in Cochrane’s quick response to the COVID-19 crisis (Garritty et al, Dec 2020) Read here

COVID-NMA: a collaborative COVID-19 living evidence project (Boutron et al, Dec 2020). Read here

Collaborating in response to COVID-19: editorial and methods initiatives across Cochrane Click here for the full report

A QuESt for speed: rapid qualitative evidence syntheses as a response to the COVID-19 pandemicBiesty et al 2020, Process paper in Systematic Reviews (Nov 2020)

Rapid review methods more challenging during COVID-19: commentary with a focus on 8 knowledge synthesis steps, in the Journal of Clinical EpidemiologyTricco et al., commentary (June 2020)

Minimising duplicate reports in estimating COVID-19 impact (July 2020). Devane, mini-commentary

Open synthesis and the coronavirus pandemic in 2020. Haddaway et al, Journal of Clinical Epidemiology (July 2020)

Strategies to improve retention in randomised trials – Cochrane Library (Gillies et al, March 2021)

Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis

Houghton et al 2020, Cochrane qualitative rapid review (April 2020).

This review was in the top 10 most highly-cited Cochrane reviews in 2021 and 2022

 

Fast-tracked prioritised update of a Cochrane review on PPE (Verbeek et al, 2020)

 

Series of rapid reviews on PPE for the Centre for Evidence Based Medicine in Oxford

Transmission characteristics of SARS-CoV-2 variants of concern (Curran et al, collaboration with ESI Fellow) March 2021

Interleukin‐6 blocking agents for treating COVID‐19: a living systematic review (Ghosn et al, Cochrane, March 2021)

Care bundles for improving outcomes in patients with COVID‐19 or related conditions in intensive care – a rapid scoping review (Smith et al, Cochrane)

  • 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)
 

Video calls for reducing social isolation and loneliness in older people Noone et al, Cochrane 21 May 2020

 

Rapid review of reviews

 

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

 

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
  • 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.
    • 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)
    • Cited in HRB Open Letter by Murphy et al as an example of PPI during COVID-19 in Ireland.
    • Follow iHealthFacts on Twitter and Facebook
    • Received continued funding from the HRB and HSE
  • Eight volunteers with Evidence Aid, an international humanitarian organisation, who contributed to a large effort toward producing and translating over evidence summaries.
  • We took part in a global network of over 75 researchers co-ordinating evidence synthesis – COVID-END – which included a guide to COVID-19 evidence sources. We were members of the International Cochrane COVID-19 Executive Response Team and the Evidence Collaborative for COVID-19 network with the WHO.