Comparison of a full systematic review versus a rapid review approaches to assess a newborn screening test for tyrosinemia type 1

Background Rapid reviews are increasingly used to replace or complement systematic reviews to support evidence based decision-making. Not enough is known about how this expedited process affects results. Objectives To assess the difference between rapid and systematic review approaches for a case study of test accuracy of succinylacetone for detecting tyrosinemia type 1. Methods Two reviewers conducted a rapid then a systematic review. The rapid review involved narrower searches, a single reviewer with 20% checking for screening the titles/abstracts and data extraction, and quality assessment using an unchanged QUADAS-2. Two reviewers performed the systematic review with a tailored QUADAS-2. Post-hoc analysis examined rapid reviewing with just a single reviewer (basic rapid review). Results The rapid and systematic reviews identified the same 10 papers, although one paper was only identified in the rapid review through checking included studies’ references. 2176 fewer title/abstracts and 129 fewer full-texts were screened during the rapid review. The unadjusted QUADAS-2 generated more ‘unclear’ ratings [29/70 (41.4%) compared to 16/70 (22.9%)], and fewer ‘high’ ratings [22/70 (31.4%) compared to 42/70 (60.0%)] than the systematic review using the adjusted QUADAS-2. A rapid review using a single reviewer would have missed up to four eligible studies during screening of titles/abstracts, and contained important inaccuracies in data extraction detected through use of a second reviewer. Conclusions Rapid reviews with 20% checking by a second reviewer appears to be an appropriate tool for policy-makers to expeditiously assess evidence. Single reviewer rapid reviews have higher risks of important inaccuracies and omissions