Pussegoda Kusala, Corrin Tricia, Baumeister Austyn, Ayache Dima, Waddell Lisa
Public Health Risk Sciences Division, National Microbiology Laboratory Public Health Agency of Canada Guelph Ontario Canada.
Cochrane Evid Synth Methods. 2024 Feb 22;2(2):e12044. doi: 10.1002/cesm.12044. eCollection 2024 Feb.
In May of 2022, several cases of mpox were identified in multiple nonendemic countries and on July 23, 2022 the World Health Organization declared mpox a Public Health Emergency of International Concern. During the first six months of the outbreak there was an urgent need to have up-to-date synthesized evidence on mpox to inform public health decision-making. At this point, evidence is changing too quickly for traditional evidence synthesis methods, as systematic reviews were out-of-date before publication. This paper describes the framework developed to manage and maintain a living evidence profile (LEP) to systematically identify, classify and synthesize evidence on a broad range of mpox topics at a rapid pace as the outbreak unfolded.
The LEP framework was based on principles of evidence synthesis, risk assessment, priority epidemiological parameters for infectious disease modeling and consultation with experts. The framework consisted of a systematic search conducted twice weekly; study selection; categorization into pre-determined foci and data extraction; integration and synthesis of evidence; internal peer-review and dissemination to stakeholders.
Between April 14 and December 15, 2022, 2287 citations were identified, 687 were primary research studies or surveillance reports on the 2022 mpox outbreak and 496 were included in the final LEP. Each study was mapped to one of 32 foci and evidence was narratively synthesized. From June to December 2022, 23 LEPs were produced (approximately weekly) along with a searchable database of extracted data of the mpox literature. They were disseminated globally to public health researchers and decision-makers to inform public health response efforts.
The LEP framework is applicable to other public health emergencies when a rapid synthesis cycle is required because the evidence is evolving quickly. This efficient methodology for creating up-to-date summaries of the current evidence during the first few months of an outbreak or emergency supports public health decision-making and response activities.
2022年5月，多个非流行国家发现了几例猴痘病例，2022年7月23日，世界卫生组织宣布猴痘构成国际关注的突发公共卫生事件。在疫情爆发的前六个月，迫切需要获取有关猴痘的最新综合证据，为公共卫生决策提供依据。此时，由于传统的证据综合方法在发表之前就已过时，证据变化太快，无法采用传统方法。本文描述了为管理和维护动态证据概况（LEP）而开发的框架，以便在疫情爆发时快速系统地识别、分类和综合一系列广泛的猴痘主题的证据。
LEP框架基于证据综合、风险评估、传染病建模的优先流行病学参数以及与专家协商的原则。该框架包括每周进行两次系统检索；研究筛选；分类到预先确定的重点领域并进行数据提取；证据的整合与综合；内部同行评审以及向利益相关者传播。
在2022年4月14日至12月15日期间，共识别出2287条引文，其中687条是关于2022年猴痘疫情的主要研究或监测报告，496条被纳入最终的LEP。每项研究都被映射到32个重点领域之一，并对证据进行了叙述性综合。2022年6月至12月，共制作了23份LEP（大约每周一份），以及一个可搜索的猴痘文献提取数据数据库。这些成果已在全球范围内传播给公共卫生研究人员和决策者，为公共卫生应对工作提供参考。
当由于证据快速演变而需要快速综合周期时，LEP框架适用于其他突发公共卫生事件。这种在疫情或紧急情况的头几个月创建当前证据最新摘要的有效方法，支持公共卫生决策和应对活动。
