Evidence-based medicine (EBM) involves the “conscientious and judicious” review and appraisal of available evidence in the making of medical decisions. In the best situations, EBM is a necessary but time-consuming step in the diagnosis, treatment, and prognosis of patients. But in the face of a novel virus pandemic, a virus with no known treatment, with imperfect diagnostic tests, and public health interventions developed on the fly, and with little to no time to peer review, EBM becomes even more challenging and more important. The effects of the COVID-19 pandemic on information access and dissemination include the development of Rapid Reviews by several organizations, and highlight the need for open science initiatives and the importance of pre-print servers. This post provides some of these resources for use by clinicians, students, and researchers.
The response to a pandemic cannot wait for the standard peer review process to play out. Hence we have seen the rise in use of preprints. Preprints are versions of papers that are complete and made public prior to peer review and publication in a journal. Preprint servers, for decades the standard for disseminating Physics (aRxiv, now maintained at Cornell University) and other information, have taken longer to take full hold in Biology and Medicine, but COVID-19 will likely have a lasting impact on their use. By posting preprints to one of these servers, authors are able to make their findings immediately available and receive feedback on manuscripts from the scientific community. Readers need to use caution and critically appraise extra carefully as preprints have not been subjected to peer review.
- bioRxiv http://connect.biorxiv.org – preprint server for biology, Cold Spring Harbor Laboratory, pronounced “bio-archive” is a free online archive and distribution service for complete but unpublished manuscripts in the life sciences.
- medRxiv http://medrxiv.org – preprint server for health sciences, Cold Spring Harbor Laboratory, British Medical Journal, and Yale University, pronounced “med-archive” is a free online archive and distribution services for complete but unpublished manuscripts in the health sciences. The COVID-19 subset for bioRxiv and medRxiv is here: https://connect.medrxiv.org/relate/content/181
- Medical Research Network (MedRN) https://www.ssrn.com/index.cfm/en/medrn/ a subset of the Social Sciences Research Network (SSRN), MedRN, including a Coronavirus “e-journal” to which one can subscribe: https://papers.ssrn.com/sol3/JELJOUR_Results.cfm?form_name=journalBrowse&journal_id=3526423
- OSF Preprints https://osf.io/preprints/ Collaborative preprint servers maintained by the Center for Open Science.
- There are others but these are some of the the primary servers.
With so much information being generated so quickly as science and medicine race to find answers, various organizations are making sense of all of this research in the form of rapid reviews. “Rapid reviews” are a form of knowledge synthesis in which components of the systematic review process are simplified or omitted to produce information in a timely manner.1 Note that these do not use the same level of rigor as a systematic review so there is potential bias introduced, so these are best reserved for when time is crucial. Here are some examples.
- Oxford Centre for Evidence Based Medicine COVID-19 Evidence Service https://www.cebm.net/covid-19/ Rapid reviews of primary care questions relating to the coronavirus pandemic, updated regularly.
- Cochrane Collaboration https://www.cochranelibrary.com/covid-19 Cochrane is developing rapid reviews and special collections related to COVID-19.
- National Collaborating Centre for Methods and Tools, McMaster University COVID-19 Rapid Evidence Reviews https://www.nccmt.ca/knowledge-repositories/covid-19-evidence-reviews
OTHER RESOURCES OF NOTE:
- COVID-19 Open Research Dataset (CORD-19) https://pages.semanticscholar.org/coronavirus-research is a free resource of over 52,000 scholarly articles, including over 41,000 with full text, about COVID-19 and the coronavirus family of viruses for use by the global research community.
- LitCovid https://www.ncbi.nlm.nih.gov/research/coronavirus/ NLM’s hub for tracking COVID-19 information. From the site: “LitCovid is a curated literature hub for tracking up-to-date scientific information about the 2019 novel Coronavirus. It is the most comprehensive resource on the subject, providing a central access to 5645 (and growing) relevant articles in PubMed. The articles are updated daily and are further categorized by different research topics and geographic locations for improved access. You can read more at Chen et al. Nature (2020) and download our data here.”
1 Khangura S, Konnyu K, Cushman R, Grimshaw J, Moher D. Evidence summaries: the evolution of a rapid review approach. Syst Rev. 2012;1:10. doi:10.1186/2046-4053-1-10.