ObjectivesThe primary objectives of this rapid health technology assessment (RHTA) were to assess the safety and effectiveness of Da Vinci surgical system compared with traditional e surgeries, so as to provide the currently-available best evidence for health decision makers and clinical workers. MethodsA comprehensive search of electronic databases (EMbase, PubMed, The Cochrane Library, Web of Science, CNKI, VIP, CBM and WanFang Data) and relevant professional HTA websites were conducted from inceptionto October 9, 2012. Two reviews independently screen literature according to the inclusion and exclusion criteria, extracted data, and assess the quality of included studies. The data based on secondary studies were reported, and a final recommendation and its level was made based on assessment outcome. ResultsA total of 21 studies were included, encompassing 7 HTAs and 14 systematic reviews/metaanalyses. The included studies involved radical prostatectomy, hysterectomy, nephrectomy, coronary artery bypass graft, and gastric fundoplication. Though the included HTAs and systematic reviews/meta-analyses focus on different diseases, the outcomes showed significant differences existed between Da Vinci surgical system and other routine surgery in clinical effectiveness and safety of different diseases. Compared with routine surgery, Da Vinci surgical system shortened hospital stay; decreased operation conversion rates, blood loss and blood transfusion rates during surgery; but it increased operative time. Besides, compared with traditional laparoscopic surgery, Da Vinci surgical system shortened operation time and hospital stay, and decreased operation conversion rates, blood loss and blood transfusion rates during surgery. ConclusionCurrent evidence shows that the clinical effectiveness and safety outcomes of Da Vinci surgical system differ in diseases. Currently, most included HTAs and systematic reviews/meta-analyses are based on observational studies, relevant prospective randomized controlled trials lack, and the evidence is graded as low quality, health decision makers are suggested to apply this evidence with caution on the basis of comprehensive consideration.
After 38 years of development, the procedure of selection and evaluation of the World Health Organization Essential Medicine List (WHO EML) is increasingly scientific and formal. However, peer review for the applications of WHO EML is always required in a short period. It is necessary to build up a set of methods and processes for rapid review. The most important items for the rapid review of WHO EML peer reviewers are: 1) to confirm the requirements and identify the purposes; 2) to establish the research questions and translate the questions into the ‘Participants, Interventions, Comparators, Outcomes, Study design' (PICOS) format; 3) to search and screen available evidence, for which high-level evidence is preferred, such as systematic reviews or meta-analyses, health technology assessment (HTA), clinical guidelines; 4) to extract data, where we extract primary information based on the purposes; 5) to synthesize data by qualitative methods, assess the quality of evidence, and compare the results; 6) to provide the answers to the applications, quality of evidences and strength of recommendations. Our study established a set of methods and processes for the rapid review of WHO EML peer review, and our findings were used to guide the reviewers to fulfill the 19th WHO EML peer review. The methods and processes were feasible and met the necessary requirements in terms of time and quality. Continuous improvement and evaluation in practice are warranted.
Since the COVID-19 outbreak, the number of studies using rapid reviews (RR) for rapid evidence-based decision-making has been increasing. RR can significantly improve the timeliness of evidence and play an important role in decision making. To clarify the definition of RR and standardize its application, the Cochrane RR Methodology Group defined RR in 2021 and published the evidence-based guidelines for RR methodology. To promote researchers' understanding of RR, standardize the application of RR methodology, and improve the overall quality of this type of research, this paper introduced the development history of RR and interpreted the definition, characteristics and methodological content of RR.