Resource use during systematic review production varies widely : a scoping review

Objective: We aimed to map the resource use during systematic review (SR) production and reasons why steps of the SR production are resource intensive to discover where the largest gain in improving efficiency might be possible.Study design and setting: We conducted a scoping review. An information specialist searched multiple databases (e.g., Ovid MEDLINE, Scopus) and implemented citation-based and grey literature searching. We employed dual and independent screenings of records at the title/abstract and full-text levels and data extraction.Results: We included 34 studies. Thirty-two reported on the resource use-mostly time; four described reasons why steps of the review process are resource intensive. Study selection, data extraction, and critical appraisal seem to be very resource intensive, while protocol development, literature search, or study retrieval take less time. Project management and administration required a large proportion of SR production time. Lack of experience, domain knowledge, use of collaborative and SR-tailored software, and good communication and management can be reasons why SR steps are resource intensive.Conclusion: Resource use during SR production varies widely. Areas with the largest resource use are administration and project management, study selection, data extraction, and critical appraisal of studies.peer-reviewe

Citation screening using crowdsourcing and machine learning produced accurate results: Evaluation of Cochrane's modified Screen4Me service

Objectives: To assess the feasibility of a modified workflow that uses machine learning and crowdsourcing to identify studies for potential inclusion in a systematic review.Study Design and Setting: This was a substudy to a larger randomized study; the main study sought to assess the performance of single screening search results versus dual screening. This substudy assessed the performance in identifying relevant randomized controlled trials (RCTs) for a published Cochrane review of a modified version of Cochrane's Screen4Me workflow which uses crowdsourcing and machine learning. We included participants who had signed up for the main study but who were not eligible to be randomized to the two main arms of that study. The records were put through the modified workflow where a machine learning classifier divided the data set into "Not RCTs"and "Possible RCTs."The records deemed "Possible RCTs"were then loaded into a task created on the Cochrane Crowd platform, and participants classified those records as either "Potentially relevant"or "Not relevant"to the review. Using a prespecified agreement algorithm, we calculated the performance of the crowd in correctly identifying the studies that were included in the review (sensitivity) and correctly rejecting those that were not included (specificity).Results: The RCT machine learning classifier did not reject any of the included studies. In terms of the crowd, 112 participants were included in this substudy. Of these, 81 completed the training module and went on to screen records in the live task. Applying the Cochrane Crowd agreement algorithm, the crowd achieved 100% sensitivity and 80.71% specificity.Conclusions: Using a crowd to screen search results for systematic reviews can be an accurate method as long as the agreement algorithm in place is robust.Trial registration: Open Science Framework: https://osf.io/3jyqt. (c) 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Values and Preferences of Patients With Depressive Disorders Regarding Pharmacologic and Nonpharmacologic Treatments A Rapid Review

Background: Developers of clinical practice guidelines need to take patient values and preferences into consideration when weighing benefits and harms of treatment options for depressive disorder.Purpose: To assess patient values and preferences regarding pharmacologic and nonpharmacologic treatments of depressive disorder.Data Sources: MEDLINE (Ovid) and PsycINFO (EBSCO) were searched for eligible studies published from 1 January 2014 to 30 November 2022.Study Selection: Pairs of reviewers independently screened 30% of search results. The remaining 70% of the abstracts were screened by single reviewers; excluded abstracts were checked by a second reviewer. Pairs of reviewers independently screened full texts.Data Extraction: One reviewer extracted data and assessed the certainty of evidence, and a second reviewer checked for completeness and accuracy. Two reviewers independently assessed risk of bias.Data Synthesis: The review included 11 studies: 4 randomized controlled trials, 5 cross-sectional studies, and 2 qualitative studies. In 1 randomized controlled trial, participants reported at the start of therapy that they expected supportive-expressive psychotherapy and antidepressants to yield similar improvements. A cross-sectional study reported that non-Hispanic White participants and men generally preferred antidepressants over talk therapy, whereas Hispanic and non-Hispanic Black participants and women generally did not have a preference. Another cross-sectional study reported that the most important nonserious adverse events for patients treated with antidepressants were insomnia, anxiety, fatigue, weight gain, agitation, and sexual dysfunction. For other comparisons and outcomes, no conclusions could be drawn because of the insufficient certainty of evidence.Limitations: The main limitation of this review is the low or insufficient certainty of evidence for most outcomes. No evidence was available on second-step depression treatment or differences in values and preferences based on gender, race/ethnicity, age, and depression severity.Conclusion: Low-certainty evidence suggests that there may be some differences in preferences for talk therapy or pharmacologic treatment of depressive disorders based on gender or race/ethnicity. In addition, low-certainty evidence suggests that insomnia, anxiety, fatigue, weight gain, agitation, and sexual dysfunction may be the most important nonserious adverse events for patients treated with antidepressants. Evidence is lacking or insufficient to draw any further conclusions about patients' weighing or valuation of the benefits and harms of depression treatments

Cost-Effectiveness of First- and Second-Step Treatment Strategies for Major Depressive Disorder A Rapid Review

Background: Major depressive disorder (MDD) is the most prevalent, disabling form of depression, with a high economic effect.Purpose: To assess evidence on cost-effectiveness of pharmacologic and nonpharmacologic interventions as first- and second-step treatments in patients with MDD.Data Sources: Multiple electronic databases limited to English language were searched (1 January 2015 to 29 November 2022).Study Selection: Two investigators independently screened the literature. Seven economic modeling studies fulfilled the eligibility criteria.Data Extraction: Data abstraction by a single investigator was confirmed by a second; 2 investigators independently rated risk of bias. One investigator determined certainty of evidence, and another checked for plausibility.Data Synthesis: Seven modeling studies met the eligibility criteria. In a U.S. setting over a 5-year time horizon, cognitive behavioral therapy (CBT) was cost-effective compared with second-generation antidepressants (SGAs) as a first-step treatment from the societal and health care sector perspectives. However, the certainty of evidence is low, and the findings should be interpreted cautiously. For second-step treatment, only switch strategies between SGAs were assessed. The evidence is insufficient to draw any conclusions.Limitations: Methodologically heterogeneous studies, which compared only CBT and some SGAs, were included. No evidence on other psychotherapies or complementary and alternative treatments as first-step treatment or augmentation strategies as second-step treatment was available.Conclusion: Although CBT may be cost-effective compared with SGAs as a first-step treatment at a 5-year time horizon from the societal and health care sector perspectives, the certainty of evidence is low, and the findings need to be interpreted cautiously. For other comparisons, the evidence was entirely missing or insufficient to draw conclusions.Primary Funding Source:American College of Physicians