How to Manage the Multiple PICOs and Challenging Timelines in Systematic Reviews for JCA Submissions

OBJECTIVES: Variability in healthcare systems and standards of care across the European Union are potentially problematic for Joint Commission Accreditation (JCA) submissions. For example, JCA-compliant systematic literature reviews (SLRs) may need to cover multiple PICO (Population, Intervention, Comparison, Outcome) criteria, required by the individual states, so posing challenges to the literature search and study-selection processes. To complete the JCA submission within the required 3-month timelines it is essential that the SLR process uses tools that can rapidly and efficiently manage multiple PICO, deliver PRISMA-aligned results, and facilitate changes in country-specific PICO. This research sought to develop and evaluate practical methods for addressing these challenges whilst meeting the JCA submission requirements and timelines.

METHODS: A past dataset from an HTA-compliant SLR on treatment for multiple myeloma was used for this research. Five distinct sets of country-specific PICO criteria were developed to simulate different combinations of populations and interventions. The Nested Knowledge (NK) screening tool was used to facilitate the screening and tagging process to mark distinct populations and interventions.

RESULTS: HTA-compliant screening was conducted for a global SLR encompassing the five country-specific sets of PICO criteria. Overall, 2621 records, followed by 321 full-texts were identified by screening against these global criteria. Forty-eight studies meeting the global PICO criteria were tagged. By selecting unique individual tags, each study was then matched with corresponding PICO criteria, providing country-specific screening results aligned with JCA requirements. Using PICO-specific tags allowed for any modifications to the country-specific PICO and subsequent updates to be promptly addressed by re-filtering the relevant tags, yielding respective screening results.

CONCLUSIONS: Our proposed methodology, using a global SLR and leveraging the NK tool, adapts the screening process to efficiently handle multiple dynamic PICO and subsequent updates. This robust approach addresses the requirements of the JCA submission process by providing rapid, accurate, and PRISMA-aligned screening results.