Ahdesmaki O, Ainsworth C, Bell J, Hawe E. Ongoing SLRs when considering HTA submissions: rewards and avoidable pitfalls. Poster presented at the Virtual ISPOR 2021 Conference; May 2021.

BACKGROUND: Systematic literature reviews (SLRs) remain the gold-standard approach for evidence synthesis to inform network meta-analysis (NMA), economic models, and associated health technology assessment (HTA) submissions. However, rigorous methodological expectations and an ever-expanding body of literature present challenges for researchers to produce timely, high-quality SLRs, which remain up to date at the time of HTA submissions, particularly in rapidly evolving therapeutic areas.

CONCEPT: Living systematic reviews are an emerging approach for performing regular updates, with pilot projects published by Cochrane, and more recently a collaboration with the World Health Organisation on the COVID-NMA initiative. To our knowledge, these methods have not yet been adapted and applied in a non-Cochrane setting assessing the relative efficacy and safety of multiple interventions and informing NMA preceding HTA submissions. This concept poster will describe key methodological considerations when planning an ongoing SLR approach to support HTA submissions.

RECOMMENDATIONS: Researchers should prepare a comprehensive, transparent search protocol covering the duration of the ongoing SLR, including consideration of: 

  1. Relevant interventions and comparators, including pipeline therapies

  2. Date limits and update frequency

  3. Timing of conference proceedings

  4. Capturing revisions to trial registry data available on Internet sources and publication of results

  5. Record management and plans for clearly reporting methodology and results

  • Resource planning should consider any overlaps between searches and potential for increased publications following conferences

  • Future requirements should be considered to minimize protocol amendments

  • Efficiency and quality may be improved through research team continuity

  • NMA should be repeated less frequently, on an as-needed basis, with consideration of the impact on the rate of false-positive results

CONCLUSIONS: Ongoing SLRs can provide a powerful, efficient tool in preparation for upcoming HTA submissions. However, researchers should take care to plan appropriately to overcome potential challenges as the relevant therapeutic landscape expands.

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