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

Evidence Synthesis Ireland Support to the Dept. of Health's Rapid Testing Expert Advisory Group

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.

  1. What is the effectiveness of different COVID-19 rapid testing strategies and different testing frequencies at detecting infectiousness or reducing transmission? 
  2. 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 
  3. 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.

Publications

Mallon Patrick WG, Horgan Mary, McAloon Conor G, Lunn Peter D, Little Julian, Beck Andrew, Bennett Alexandria, Shaver Nicole, McConway Aileen, O’Regan Rhea, Whelan Barbara, Rapid Testing Expert Advisory Group, Ireland. 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

Collaborating in response to COVID-19: editorial and methods initiatives across Cochrane

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

Evidence Synthesis Methodology publications

Biesty et al 2020, Process paper in Systematic Reviews (Nov 2020)

Tricco…, Houghton, Devane et al commentary (June 2020)

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)

Personal Protective Equipment reviews

Houghton et al 2020, Cochrane qualitative rapid review (21 April 2020)

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

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

Healthcare and mental health reviews

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

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
Mapping of evidence
Health claims – fact checked
  • 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
Education
Evidence, collaboration and co-ordination
  • 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.
Ongoing work

COVID-NMA systematic reviews (led by Prof Devane, with F Quirke et al)

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