NIHR Complex Reviews Support Unit (CRSU)
In April 2018 Paul Hine, from the Cochrane Infectious Diseases Group (CIDG) editorial base, attended a Complex Reviews Support Unit (CRSU) Workshop, at GCU London. The workshop was well-attended, with representatives from different Cochrane Groups from across the UK.
The aim of the workshop was to highlight how the CRSU can support complex reviews. But what is a “complex review”?
A recent BMJ blog by Kamal Mahtani and colleagues, 'What makes a systematic review complex', proposes the following definition for a complex review: “A systematic review consisting of multiple components, large amounts of data from different sources, and different perspectives, united or connected, collectively contributing more than would be expected from their individual contributions; the components are not easily coordinated, analysed, or disentangled.” However, Professor Nicola Cooper, Deputy Director of the CRSU, suggested that many reviews will become complex in different ways that a single definition cannot encapsulate.
David Tovey, Editor-in-Chief of Cochrane, introduced the Workshop by describing the evolving challenge of reviews from the perspective of Cochrane. The organisation stands at a crossroads, with increasing moves beyond conventional reviews of whether a drug does or doesn’t work. David Tovey highlighted the goals for Cochrane: Ask the right questions. Use the right data. Use the right methods. Maximise impact. He emphasised how we must think about how end users will use the reviews we write.
The CRSU is funded by the National Institute for Health Research (NIHR), and aims to support successful delivery of complex reviews funded and/or supported by the NIHR – this includes Cochrane reviews with UK-based authors. They aim to achieve this by developing capacity and capability. The workshop demonstrated some of the areas in which they work, with a particular focus on network meta-analysis and reviews of diagnostic test accuracy. They showcased the exciting development of new interactive web-based tools for conducting these reviews. These are freely available on their website using the links below. These tools are yet to be used in a Cochrane Review, but offer an exciting way to facilitate complex reviews.
Dr Hilary Thomson delivered another highlight talk within the workshop about narrative synthesis within systematic reviews. She highlighted the lack of transparency in the methods used in narrative synthesis, raising concerns that it is too often an afterthought when reviewers are unable to meta-analyse. There were no simple solutions, but she gave a strong case that authors should develop methods for narrative synthesis at the protocol stage.
This workshop was particularly relevant, as increasingly the Cochrane Infectious Diseases Group is moving towards conducting more complex reviews. It was lively and interactive, highlighting exciting opportunities for the CIDG moving forward.