Living systematic review series published in Journal of Clinical Epidemiology

Living systematic review series published in Journal of Clinical Epidemiology

Hot off the press and hot on the tail of the publication of Cochrane’s first living systematic reviews on the Cochrane Library, the LSR Network is pleased to announce that it has published a series of four articles in the September issue of the Journal of Clinical Epidemiology, along with a commentary by Alex Sutton.

Here’s a brief overview of each of the articles:

Living Systematic Reviews: 1. Introduction - the Why, What, When and How (Julian Elliott et al)

Systematic reviews are difficult to keep up to date, and failure to do so leads to a decay in review currency, accuracy and utility. We are developing an approach to systematic review updating we term ‘living systematic review’ (LSR): systematic reviews which are continually updated, incorporating relevant new evidence as it becomes available. We hypothesise that a continual approach to review updating will achieve greater currency, and therefore accuracy and benefits to end users, with feasible resource requirements over time.

Living Systematic Reviews: 2. Combining Human and Machine Effort (James Thomas et al)

This paper outlines the way in which new technologies – which encompass human and machine effort – can make the living systematic review approach viable and sustainable. This paper describes the potential – and limitations – of new ways of undertaking specific tasks in living systematic reviews. It pinpoints areas where these human / machine technologies are already ready for use, and where further research and development is needed. We consider each stage of the LSR process, and describe how people and machines can cooperate in mutually supportive ways.

Living Systematic Reviews: 3. Statistical Methods for Updating Meta-Analyses (Mark Simmonds et al)

Frequent updating increases the likelihood of changing the conclusions of the meta-analyses. If using standard meta-analysis methods, with conventional 95% confidence intervals. The chance of incorrectly concluding that any updated meta-analysis is statistically significant when there is no effect (Type I error) increases as more updates are performed. Inaccurate estimation of any heterogeneity across studies may also lead to inappropriate conclusions, particularly when there are few studies in the analysis. New statistical approaches are needed to better handle these challenges.

Living Systematic Reviews: 4. Living Guideline Recommendations (Elie Akl et al)

Living Guidelines linked to living systematic reviews holds the promise of providing timely, up-to-date and high quality guidance to target users. However, achieving living guidelines requires specific methodology for their set up, continual development, and dissemination. This paper defines living guidelines and discusses when they are appropriate, the workflows required to support them, the thresholds for changing recommendations, and potential approaches to publication and dissemination.

We welcome your questions, comments, and feedback about these articles – please get in touch with us via


Support for Project Transform was provided by Cochrane and the National Health and Medical Research Council of Australia (APP1114605). The contents of the published material are solely the responsibility of the Administering Institution, a Participating Institution or individual authors and do not reflect the views of the NHMRC.

Support for the Cochrane Review 'Interventions for increasing fruit and vegetable consumption in children aged five years and under' and application of machine/crowd technologies to monthly searches was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.


12 September 2017