Cochrane’s COVID-19 living systematic reviews: a mixed-methods study of
their conduct, reporting and currency
Abstract
Background Living systematic reviews (LSRs) should provide up-to-date
evidence for priority questions where the evidence maybe uncertain and
fast-moving. LSRs featured prominently during COVID-19 and formed part
of Cochrane’s response to the pandemic. We conducted a mixed-methods
study to describe the characteristics of Cochrane’s COVID-19 living
reviews, determine the currency of the included evidence, and evaluate
authors’ experiences in conducting and publishing these reviews. Methods
We identified living reviews of COVID-19 from the Cochrane Database of
Systematic Reviews and extracted data on the number of versions
published and publication timelines. We assessed the currency of
evidence by comparing studies included in the reviews against a
comprehensive list of studies maintained for the Australian living
guidelines for COVID-19. The qualitative component involved
semi-structured interviews with review authors to identify the barriers
and enablers to conducting, reporting and publishing living reviews.
Findings Cochrane published 25 COVID-19 living systematic reviews. Half
of these reviews had not been updated when assessed in June 2023 and
only four had been updated more than once. A total of 118 studies were
included in the living reviews. We estimated that an additional 119
studies were available and potentially relevant for inclusion.
Interviews with six authors indicated that publication timelines were
reduced by editorial delays, loss of funding, waning commitment, and the
burden of screening search results. An inability to communicate the
living status of reviews in the Cochrane Library was a common
frustration for many authors. Although authors felt the conclusions of
their reviews were still current, only one living review communicated
its update status and made new evidence accessible after the review was
published. Conclusions Maintaining and communicating the currency of
Cochrane’s COVID-19 living systematic reviews was not feasible for many
author teams because of author-side, editorial and platform barriers.