Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study
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OBJECTIVE: To simulate possible changes in systematic review results if rapid review methods were used. STUDY DESIGN AND SETTING: We recalculated meta-analyses for binary primary outcomes in Cochrane systematic reviews, simulating rapid review methods. We simulated searching only PubMed, excluding older articles (5, 7, 10, 15, and 20 years before the search date), excluding smaller trials (<50, <100, and <200 participants), and using the largest trial only. We examined percentage changes in pooled odds ratios (ORs) (classed as no important change [<5%], small [<20%], moderate [<30%], or large [≥30%]), statistical significance, and biases observed using rapid methods. RESULTS: Two thousand five hundred and twelve systematic reviews (16,088 studies) were included. Rapid methods resulted in the loss of all data in 3.7-44.7% of meta-analyses. Searching only PubMed had the smallest risk of changed ORs (19% [477/2,512] were small changes or greater; 10% [260/2,512] were moderate or greater). Changes in ORs varied substantially with each rapid review method; 8.4-21.3% were small, 1.9-8.8% were moderate, and 4.7-34.1% were large. Changes in statistical significance occurred in 6.5-38.6% of meta-analyses. Changes from significant to nonsignificant were most common (2.1-13.7% meta-analyses). We found no evidence of bias with any rapid review method. CONCLUSION: Searching PubMed only might be considered where a ∼10% risk of the primary outcome OR changing by >20% could be tolerated. This could be the case in scoping reviews, resource limitation, or where syntheses are needed urgently. Other situations, such as clinical guidelines and regulatory decisions, favor more comprehensive systematic review methods.
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The inability to access additional proprietary databases such as EMBASE might modestly harm the recall of the system.
“At present, we make use of articles from PubMed onlydwe are unable to access additional proprietary databases such as EMBASE which might (modestly) harm the recall of the system [27].”
From In a pilot study, automated real-time systematic review updates were feasible, accurate, and work-saving (2023) · cites this paper as [27]
Evidence suggests that limiting a search to a set number of years can cause studies to be lost and can change meta-analysis results.
“evidence suggests that limiting the search to a set number of years may lead to a loss of studies and a change in the results of meta-analyses [28].”
From Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews (2021) · cites this paper as [28]
In that study, most effect size changes were small to moderate, and significant changes were relatively common.
“In this study, most effect size changes were small but moderate, and significant changes were relatively common.”
From Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews (2021) · cites this paper as [28]
Removing studies that were not indexed in MEDLINE from meta-analyses had only little impact on effect estimates.
“Removing studies that were not indexed in MEDLINE from the meta-analyses had only little impact on the effect estimates [3,4,6].”
From Searching two or more databases decreased the risk of missing relevant studies: a metaresearch study (2022) · cites this paper as [6]
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Norman, G., Wilson, P. M., Dumville, J. C., Bower, P., & Cullum, N. A. (2022) · Systematic Reviews · doi:10.1186/s13643-022-02106-z · Cited by 8 · see citing works
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Shek, C. H., Chan, S. W., Stubbs, M. A., & Lee, R. (2024) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2024.055706 · Cited by 14 · see citing works
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Dones Valentin, C. (2022) · Journal of Musculoskeletal Disorders and Treatment · doi:10.23937/2572-3243.1510112 · Cited by 6 · see citing works
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Norman, C. R. (2020) · theses.fr (ABES) · doi:10.70675/044ffa34z5c9bz433az99c8z64697dcd28a2 · Cited by 5 · see citing works
Glove breach occurrence during surgical procedures: the benefits of double/indicator system gloves
Rippon, M. G., Rogers, A. A., & Ousey, K. J. (2025) · Journal of Hospital Infection · doi:10.1016/j.jhin.2025.04.010 · Cited by 5 · see citing works
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Öğüt, Ç., & Öğüt, N. D. (2022) · Psychiatric annals · doi:10.3928/00485713-20221220-02 · Cited by 4 · see citing works
Sadlon, A., Ott, M., & Kressig, R. W. (2023) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2023.1256968 · Cited by 4 · see citing works
Wang, L., Rouse, B., Marks‐Anglin, A., Duan, R., Shi, Q., Quach, K., Chen, Y., Cameron, C., Schmid, C. H., & Li, T. (2019) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2019.06.010 · Cited by 4 · see citing works
Véras, M. M. S., Sigouin, J., Auger, C., Auger, L.-P., Ahmed, S., Boychuck, Z., Cavallo, S., Lévesque, M., Lovo, S., Miller, W. C., et al. (2024) · Digital Health · doi:10.1177/20552076241260367 · Cited by 3 · see citing works
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Ganeshananthan, R., Xu, Z. C., Brumpton, K., Jones, B., & Pinidiyapathirage, J. M. (2022) · AlterNative An International Journal of Indigenous Peoples · doi:10.1177/11771801221118114 · Cited by 3 · see citing works
Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol
Tardif, P., Moore, L., Lauzier, F., Farhat, I., Archambault, P. M., Lamontagne, F., Chassé, M., Stelfox, H. T., Gabbe, B. J., Lecky, F. E., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031747 · Cited by 3 · see citing works
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Harper, M., Rytwinski, T., & Cooke, S. J. (2023) · Environmental Management · doi:10.1007/s00267-023-01901-1 · Cited by 2 · see citing works
Tomotaki, A., Kodama, Y., & Futami, A. (2024) · Journal of Japan Academy of Nursing Science · doi:10.5630/jans.44.117 · Cited by 2 · see citing works
Morand-Grondin, D., Berthod, J., Sigouin, J., Beaulieu‐Bonneau, S., & Kairy, D. (2025) · JMIR Research Protocols · doi:10.2196/66639 · Cited by 2 · see citing works
Opportunities to improve reporting of rapid response in health technology assessment
de Almeida, M. O., Montezuma, T., de Oliveira, H. A., & Ferri, C. P. (2021) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462321000635 · Cited by 2 · see citing works
Need for greater transparency in documenting informed consent
Tugwell, P., & Knottnerus, J. A. (2019) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2019.04.004 · Cited by 2 · see citing works
Goyal, A., Tariq, M. D., Ahsan, A., Khan, M. H., Zaheer, A., Jain, H., Maheshwari, S., & Brateanu, A. (2025) · World Journal of Methodology · doi:10.5662/wjm.v15.i4.102290 · Cited by 1 · see citing works
Yun, Q., Lin, M. C., Jia, Y., Wang, Y., Zhang, J., Sha, F., Yang, Z., & Tang, J.-L. (2024) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2024.111265 · Cited by 1 · see citing works
Framing evidence synthesis production with the lens of sustainable knowledge
Gabriel Rada, G., Ávila, C., Pesce, F., & Verdugo‐Paiva, F. (2025) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2025.112027 · Cited by 1 · see citing works
Morand-Grondin, D., Berthod, J., Sigouin, J., Beaulieu‐Bonneau, S., & Kairy, D. (2026) · Health Informatics Journal · doi:10.1177/14604582261431026 · Cited by 1 · see citing works
de Oliveira, J. M. D., Mello, A. T., Scandolara, D. H., Celuppi, I. C., Rampinelli, V. P. C., Wazlawick, R. S., & Dalmarco, E. M. (2026) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2026.106516 · Cited by 1 · see citing works
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Martin, J., Leonard, J., & Sibbald, S. L. (2021) · Western Undergraduate Research Journal Health and Natural Sciences · doi:10.5206/2020-20.3 · Cited by 1 · see citing works
Sharififar, S., Dadashi, A., Orandi, A., Malekabad, E. S., Khorramnia, S., & Noodeh, F. A. (2022) · Studies in Medical Sciences · doi:10.52547/umj.32.10.782 · Cited by 1 · see citing works
Topic Reviews in Neurosurgical Journals: An Analysis of Publication Trends
Begley, S. L., Pelcher, I., & Schulder, M. (2023) · World Neurosurgery · doi:10.1016/j.wneu.2023.08.101 · Cited by 1 · see citing works
Rapid Evidence Synthesis To Enable Innovation And Adoption in Health and Social CarePreprint
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Pharmacist interventions to deprescribe benzodiazepines in older adults: A missed opportunity?
Cadogan, C. A. (2022) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2022.05.012
Gilligan, T., & Robinson, A. (2025) · Radiography · doi:10.1016/j.radi.2025.103201
Nama, N., Hennawy, M., Barrowman, N., O'Hearn, K., Sampson, M., & McNally, J. D. (2021) · Figshare · doi:10.6084/m9.figshare.14374721
Nama, N., Hennawy, M., Barrowman, N., O'Hearn, K., Sampson, M., & McNally, J. D. (2021) · Figshare · doi:10.6084/m9.figshare.14374727
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Kairuz, C. A., Casanelia, L. M., Bennett‐Brook, K., Coombes, J., & Yadav, U. N. (2021) · Figshare · doi:10.6084/m9.figshare.14906140
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Nama, N., Hennawy, M., Barrowman, N., O'Hearn, K., Sampson, M., & McNally, J. D. (2021) · Figshare · doi:10.6084/m9.figshare.14374733
Nama, N., Hennawy, M., Barrowman, N., O'Hearn, K., Sampson, M., & McNally, J. D. (2021) · Figshare · doi:10.6084/m9.figshare.14374745
Scharfe, J., Pfisterer‐Heise, S., Kugler, C. M., Shehu, E., Wolf, T., Mathes, T., & Pieper, D. (2023) · Figshare · doi:10.6084/m9.figshare.22614592
Nama, N., Hennawy, M., Barrowman, N., O'Hearn, K., Sampson, M., & McNally, J. D. (2021) · Figshare · doi:10.6084/m9.figshare.14374739
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Nama, N., Hennawy, M., Barrowman, N., O'Hearn, K., Sampson, M., & McNally, J. D. (2021) · Figshare · doi:10.6084/m9.figshare.14374742
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Dewidar, O., Dawit, H., Sabri, H., Chan, A., Turko, R., Lane, T., Rizvi, A., Ghogomu, E. T., Funnell, S., & Welch, V. A. (2026) · Poverty & Public Policy · doi:10.1002/pop4.70058
Risk of Bias in Rapid Reviews: Omission, Adaptation and TransparencyPreprint
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Hänig, T., & Petzold, T. (2026) · Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen · doi:10.1016/j.zefq.2026.04.006
Bugre, A., Fletcher, A. J., & Reed, M. G. (2026) · Sustainability · doi:10.3390/su18126354
Grenet, G., Eskandari, R., Ko, J., Adams, S. P., Salzwedel, D. M., Heran, B. S., Ambasta, A., Bassett, K., & Thompson, W. (2026) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2026-006225
Leightley, D., Varghese, R., Khatun, T., Marshall, I., Dymond, S., Simms, A., Finnegan, A. P., & Williamson, C. (2026) · Research Square · doi:10.21203/rs.3.rs-11376106/v1
Self-citation
- Authors
- Marshall, I. J., Marshall, R., Wallace, B. C., Brassey, J., & Thomas, J.
- Affiliations
- Northeastern University (US)
- University College London (GB)
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2019-05
- Volume
- 109
- Pages
- 30-41
- ISSN
- 0895-4356 (ISSN-L)
- PMC
- PMC6524137
- OpenAlex
- W2906313111
- Cited by
- 95
- References
- 39
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 9 · 2023: 10 · 2022: 22 · 2021: 23 · 2020: 11 · 2019: 7
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Clinical Epidemiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Medical Research Council
- Agency for Healthcare Research Quality (R03-HS025024)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- rapid review, systematic reviews, meta-epidemiology, PubMed search, scoping review
- MeSH terms
- Systematic Reviews as Topic, Epidemiologic Methods, Humans, Review Literature as Topic, Epidemiologic Studies, PubMed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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