“There are now 75 trials, and 11 systematic reviews of trials, per day and a plateau in growth has not yet been reached”
Many Australians would be surprised to learn that most of the recommendations and guidelines that shape the healthcare they receive are not based on the latest high-quality research evidence or findings from clinical trials.
In many fields, rigorous clinical guidelines are only produced every 3 to 5 years, while research findings appear every month. This means that many patients may not be getting advice or treatment based on the latest evidence, but rather what was considered best practice whenever the relevant guidelines were last updated (sometimes up to 10 years earlier).
Australian clinical guidelines are developed by expert panels and based on rigorous systematic reviews of the relevant research, but most are out of date - primarily because guideline panels can’t keep up with the deluge of new findings being published by researchers around the world.
The widely referenced quote above was published in 2010. Almost a decade later, the enormity of the challenge to reliably aggregate and make sense of the results of an ever increasing number of research studies, compounded by the exponential accumulation of real-world data (from health system databases, wearable devices, apps and social networks), remains largely undressed.
The Australian Government’s commitment to doubling health and medical research, through landmark measures such as the Medical Research Future Fund (MRFF), recognises the transformative potential of research to improve the health of Australians and drive productivity and economic growth.
In partnership with the research sector, the Australian Government has built strong support for this level of investment from the Australian public, who trust that research leads to better heath care.
Maximising the value of the vast body of research in any area of health requires a rigorous process of finding and analysing all of the research relevant to that topic – a process known as evidence synthesis – to produce reliable recommendations that inform clinical practice, policy making, licensing and reimbursement, and program investments.
The methods for this critical step in research translation are well developed, but the systems are outdated, inefficient, drowning in a deluge of research data, and failing to harness innovations in technology that are driving the data revolution in many other fields.
To deliver the potential benefit of Australia’s rapidly growing investments in health and medical research, we need systems that can fast-track the synthesis and dissemination of reliable evidence to point-of-care and policy making.
No matter where they live or which health service they access, Australians should receive health care based on the best available evidence. Evidence-based guidelines aim to minimise unwanted variations in care by ensuring everyone involved in health care decisions is kept up-to-date with what we know and what we should do.
The current approach to updating guidelines intermittently can no longer keep pace with the speed of research and far too many Australian guidelines are out of date and underutilised. This is delaying widespread access to newer more effective treatments and prolonging exposure to those that are ineffective or harmful.
Enabled by early investment from the National Health and Medical Research Council (NHMRC), Cochrane Australia and partners are building a suite of tools and processes to enable near real-time updating of guidelines and policy recommendations. This innovative approach uses advanced technologies such as text mining, machine learning and citizen science in a ‘living’ model of continuous evidence synthesis and dissemination.
The Living Evidence model has the potential to reduce the lag time between research publication and incorporation into evidence-based recommendations from years to weeks, and to reduce the time and unit costs involved by 75%.
This is why leading experts in evidence synthesis, automation technologies and guideline development in stroke, diabetes, kidney disease, musculoskeletal conditions and heart disease have come together with Cochrane Australia to lead a world-first consortium effort, united in a shared understanding of the urgent need to accelerate the development of Living Evidence capacity in Australia.
The Australian Living Evidence Consortium aims to deliver a series of frontier projects and provide the vital early leadership and coordination needed to build national capability for Living Evidence across the Australian health system.
