Skip to main content

Table 3 Summary characteristics of the three reviews, review challenges and approaches and strengths and limitations of chosen methods

From: The use of rapid review methods in health technology assessments: 3 case studies

Report and no. RCTs Populations, interventions and comparators Review challenges and approaches Strengths and limitations of chosen method
Kaltenthaler et al. 2014 [12]
Sexual health of people with severe mental illness
13 RCTs
Review aims: summarise effectiveness evidence, determine applicability in UK NHS setting and identify key areas for primary research.
Population: people with severe mental illness
Interventions: strategies to increase knowledge, assess and reduce sexual health risk, change behaviour and develop condom skills
Comparators: educational sessions on HIV, money management or substance abuse, health promotion, wait list or no treatment
Challenges due to evidence base:
 • Wide variation in populations and settings (patients in psychiatric clinics, residential centres and homeless shelters)
 • Wide range of outcomes including: biological (sexually transmitted infections, pregnancy), behavioural (number of partners, uptake of services, use of contraception/condoms) and proxy (knowledge, attitudes, behaviours, facilitators and barriers etc.)
Approaches:
 • Focussed definition of severe mental illness
 • Brief summary of results presented, narrative synthesis, grouping of results from included studies by outcome (biological, behavioural and proxy)
Strengths:
 • Enabled rapid synthesis of a disparate evidence base to ensure policy makers were aware of areas where evidence was available. This informed the design of relevant RCTs
Limitations:
 • Quantitative data synthesis not generated for use by policy makers (only effect size by intervention and outcome)
 • In-depth narrative synthesis not possible
 • Non-RCT evidence excluded
Cooper et al. (2015) [13]
Premature ejaculation
101 RCTs and 1 CT (65 RCTs from existing reviews and 36 new RCTs and 1 new CT reports)
Review aims: synthesise effectiveness evidence for behavioural, topical and systemic treatments.
Population: men with premature ejaculation
Interventions: topical anaesthetics, antidepressants, phosphodiesterase-5 inhibitors, opioid analgesics, behavioural therapies, acupuncture, Chinese medicine
Comparators: placebo, wait list, other therapies
Challenges due to evidence base:
 • Very large number of RCTs (over 100) and existing systematic reviews covering wide range of interventions (several drug classes plus behavioural approaches)
 • Several existing systematic reviews
Approaches:
 • Meta-analysis of primary outcome using data extracted from existing systematic reviews, with new primary study data added
 • Narrative synthesis of secondary outcomes
Strengths:
 • Meta-analysis able to be used for primary outcome (consistent primary outcome)
 • Use of data from existing reviews enabled meta-analysis of large dataset in shorter time
Limitations:
 • Potential for data errors or synthesis errors in original reviews to be repeated in new report
 • Methodological quality of studies extracted from existing reviews not assessed separately
 • Although use of data from existing reviews saved some time, triangulation of data from multiple reviews was still time-consuming
 • Original RCT publications not revisited for data extraction and quality assessment.
Cooper et al. (2015) [14]
Cannabis cessation
33 RCTs
Review aims: summarise effectiveness evidence for psychological and psychosocial interventions and identify key areas for primary research.
Population: adults who use cannabis regularly
Interventions: cognitive behavioural therapy, motivational interviewing, motivational enhancement therapy, supportive-expressive dynamic psychotherapy, social support groups, case management, contingency management (vouchers as incentive/reward)
Comparators: waitlist, treatment as usual, other interventions, assessment only, education controls, written cannabis information, cannabis education
Challenges due to evidence base:
 • Wide variation in study populations (extent of cannabis dependence), interventions (type, duration) and comparators
 • Very little consistency in outcome measures, time points, and statistics reported
 • Large number of RCTs for a short report
Approaches:
 • For each pair of interventions compared, narrative summary of outcomes reported and how many showed a statistically significant effect
Strengths:
 • Inclusive approach, covering a wide range of populations, interventions and outcomes
 • Included all psychosocial or psychological interventions undertaken in the adult, community dwelling population of cannabis users
Limitations:
 • Detailed numerical outcome data not presented, since outcome measures and statistics reported were so disparate
 • Outcome measures in RCTs not converted to consistent measures to compare across studies as not feasible in timeframe
  1. CT controlled trial