WHAT IS 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.

our program focus

We’re embarking on an ambitious program of work to establish Living Evidence as the new benchmark for using evidence more effectively within the Australian healthcare system.

Our program will be driven by Frontier Projects to develop living guideline recommendations for some of Australia’s most pressing health conditions including stroke, diabetes, kidney disease, musculoskeletal conditions and heart disease.

PLATFORMS

Integration
Current software and databases for creating and using evidence are efficient, but fragmented, constraining the impact these systems can have on the evidence ecosystem as a whole. We aim to integrate these platforms into an end-to-end system with a unified technical architecture and coherent user experience.

Automation
We aim to extend the artificial intelligence and citizen science technologies across the evidence workflow and integrate with user-facing software systems to significantly reduce the time and effort of producing evidence and guidance.

Data re-use
Currently, each evidence assessment starts from scratch. We aim to extend the breadth and depth of our metadata systems to enable evidence partners to reuse the work generated by our global user base, substantially improving efficiency. Over time we will support a move towards a model of curating research datasets and generating reliable evidence immediately and directly.

PROCESSES

Living methods
We will extend existing work in Cochrane living systematic reviews and use living guideline Frontier Projects to further develop, test, evaluate and scale approaches for near real-time production of evidence and guidance, including evidence surveillance; workflow and team management; statistical analyses; and publication, dissemination and adoption of living recommendations.

Diverse data
We will expand the data sources routinely used in evidence synthesis, enabling the efficient incorporation of Clinical Study Reports (CSRs) and individual-level trial and observational data. These data are highly useful but require further development of statistical methods, partnerships and technical systems to fully exploit their value.

Decision-making
Existing multi-layered digital evidence and guidance outputs will be more closely connected to patients and health care professionals at the point-of-care, including adaptation of current multi-device formats to support living processes, integration with Australian clinical decision support systems and support for knowledge translation activities, particularly clinical registry integration and audit and feedback.

PARTNERSHIPS

Frontier Projects
Guided by the world’s leaders in knowledge translation and consumer participation, we will support multi-stakeholder partnerships around our Frontier Projects that create a culture of evidence, delivering co-production and use of evidence in high-priority, high-burden chronic conditions in Australia.

Workforce capability
We will expand the capability of the evidence workforce participating in Frontier Projects and beyond. This will build on Cochrane Australia’s leadership in training and capacity building and leverage our partnerships, the community networks supported by this initiative, and intersections with the Platforms program.

Robust program evaluation
We will measure the impact of Frontier Projects on the production and use of evidence in the those health areas. This work will document and explain the concordance of initiative outcomes with defined goals and objectives, and explore impacts on downstream processes, including practice change and individual patient outcomes.