About Living Evidence

Living Evidence uses continuous evidence surveillance and rapid response pathways to incorporate new relevant evidence into systematic reviews and clinical practice guideline recommendations as soon as it becomes available.

Practically, this means that living systematic reviews and living guidelines:

• Are underpinned by continual, active evidence surveillance and monitoring.
• Rapidly incorporate new important evidence that is identified.
• Can communicate in near real-time the current status of the review or guideline, and any new evidence being incorporated in the recommendation/s.

In addition to continuous updating, Living Evidence aims to improve the quality, use and value of evidence synthesis activities by:

• Engaging large and diverse groups of stakeholders to be actively engaged in finding and appraising evidence.
• Broadening the range of research and health-related data that can be included, such as real-world data from clinical quality registries and individual patient-level data.
• Publishing recommendations in multi-layered digitals formats that can be integrated at the point of care into electronic medical records and decision support tools.
• Using structured (semantic) data to improve the discoverability and re-use of research and health-related data.

The Collaboration uses a world-leading Living Evidence approach, which combines rigorous, evidence-based methods and rapid updating. This enables us to modify and update recommendations rapidly in response to the publication of new research evidence.

The guidelines use the GRADE methods and are designed to meet Australian NHMRC standards.

Relevant new questions to be addressed are continually sought from stakeholders and practitioners. For prioritised questions, the evidence is actively monitored and updated. Evidence surveillance combines horizon scans and targeted searches.

An evidence team appraises and synthesises evidence and prepares evidence-to-decision frameworks to inform development of recommendations by multidisciplinary clinical panels.

A guidelines leadership group oversees the development of recommendations by these expert panels and is advised by a consumer panel.

After initial approval by the Guidelines Leadership Group, all recommendations require 100% consensus by our 35 member organisations.

Endorsed recommendations are published online in MAGICapp and disseminated through traditional and social media channels.

1. Literature searches (Daily, weekly or monthly as required)
2. Publications screened, included studies appraised, Evidence Profile and Summary of Findings tables developed or added to (as required)
3. Guideline Panels (clinical and consumer) consider new evidence and draft guidance – recommendations and Flowcharts (as required)
4. Guideline Leadership Group reviews all draft recommendations from Expert Clinical Panels, and approves for submission to Steering Committee (as required) 
5. Steering Committee reviews and approves new and updated recommendations for publication (as required)

Find out more about evidence-based guideline development and GRADE methods:

• NHMRC Guidelines for Guidelines
• Melbourne GRADE Centre
• ANZ Guideline Network
• The Grade working group
• MAGIC GRADE and methodology

• COVID-19
• Pregnancy care
• Postnatal care

The global response to the COVID-19 pandemic highlighted the many ways a shared sense of urgency can break down traditional barriers to innovation and collaboration, and deliver extraordinary results. Here in Australia, the National Clinical Evidence Taskforce harnessed collective commitment and multi-disciplinary expertise to deliver the world-first infrastructure, networks and know-how to deliver living clinical guidelines. As a result, clinicians were equipped with near-real time, trusted evidence in crisis conditions.

The Taskforce demonstrated that partnerships are a foundational element of living evidence production, drawing on national professional, research and consumer groups and global organisations including WHO, NICE, Cochrane Canada and the Danish Health Authority.

The resulting infrastructure, processes and genuinely collaborative model that emerged enabled 200+ contributors from 35 national peak health bodies representing all major clinical groups to deliver the trusted evidence Australians urgently needed each week over the past three years.

Together, the Taskforce’s 15 expert panels developed 23 clinical flowcharts and updated the national COVID-19 clinical guidelines over 100 times with more than 200 recommendations. Clinical scope expanded over time to include guidance for the care of children, adolescents, adults, pregnant or breastfeeding women, and older people – highlighting the viability, impact and value of living evidence now and into the future.

To find out more about the impact of the Taskforce visit at evidenceinaction.org/