Cochrane Airways approach to priority setting

Why prioritise?

Cochrane Airways aim to publish the reviews that are most important to today’s decision-makers. We believe it is important to identify work that we are not going to do as well as thinking about what priority reviews we will do. In other words if priority-setting adds more work to the day-to-date work involved in publishing reviews, then we have failed.

Effective prioritisation can be complicated because we have over 290 reviews on several distinct disease areas. Two of these (asthma and COPD) are highly-active areas of research because there are so many people affected by these diseases. This means there is a vast number of trials. People with asthma or COPD have different disease characteristics (phenotypes) and so there is the additional challenge of different treatments being relevant for different populations. We also have several smaller disease areas such as bronchiectasis, interstitial lung disease and sleep apnoea to consider where there is less evidence from clinical trials. We hope a workable prioritisation strategy will help us to make sensible choices that maximise benefits for those affected by these conditions.

What are we doing?

We have published 11 out of 30 reviews that we highlighted for prioritisation using methods described here. Several other review updates are underway. In brief, we surveyed our editorial boards, considered the most highly accessed (on the web) and cited reviews and considered published patient concerns about asthma to arrive at the list of priority review updates (Welsh 2014).

Our approach to priority setting is down-to-earthand adaptable.For instance, in order to obtain funding, we had to demonstrate that patients would have a say in the review topic choices. Therefore we held a priority-setting workshop in which participants proposed review topics and ranked them to give the top ten patient questions. We then used the questions identified to develop review topics which are now being drafted.

What are we not doing?

We stopped running routine update searches for reviews with no new studies, unless there is a strong reason for doing so. We previously ran yearly searches for all reviews and send them to author teams, but now we run fewer searches, which are for priority reviews with active author teams. We do not allow author teams to update reviews which we do not think are a priority; this means that the work we do is priority driven rather than author-led. However, we are always open to discussion about priority lists and willing to change our minds if there is a strong case to do so!

More information and contact details can be found here.

About the Author : Dr Emma Welsh is the Managing Editor, Cochrane Airways Group and works at Population Health Research Institute, St George's University of London, London, UK.