Can Living Systematic Literature Reviews Reduce Research Wastage? An Evaluation of LiveSLR®

OBJECTIVES: Living systematic reviews (LSRs) could enable timely health technology assessment (HTA) in diseases with rapidly emerging evidence. LSRs can be supported by tools such as the web-based platform, LiveSLR®. We assessed the feasibility of utilizing LiveSLR® to support HTAs by reviewing SLRs registered on the PROSPERO systematic review (SLR) protocol registry.

METHODS: Medical subject heading (MeSH) terms were used to search PROSPERO for 26 indications covered by LiveSLR® (May 24, 2024). Records were screened for outcomes relevant to HTA (clinical efficacy/effectiveness, healthcare resource utilization [HCRU]/costs, health-related quality of life). SLRs were categorized according to their replicability using LiveSLR®: ‘replicable’ (overlap with indication; research question answerable with existing data) or ‘replicable with adaptation’ (overlap with indication; research question answerable by expanding the SLR). SLRs not included in the search results were considered ‘not replicable’ (no overlap with indication).

RESULTS: Of 3,319 SLRs identified, 2,902 were ‘replicable with adaptation’ and 417 were ‘replicable’: 88 prostate cancer (PC), 65 non-muscle invasive bladder cancer (NMIBC), 47 severe asthma (SA), 35 ulcerative colitis (UC), 34 non-small cell lung cancer (NSCLC), 30 systemic lupus erythematosus (SLE), 20 colorectal cancer (CRC), 14 small cell lung cancer (SCLC), and 10 multiple myeloma (MM) SLRs. Indications with <10 replicable SLRs were not reported.

LSRs could replicate clinical efficacy and effectiveness SLRs in NMIBC, SA, UC, NSCLC, CC, PC, SCLC, and MM; humanistic burden of illness in NMIBC, UC, SLE, PC, and SCLC; HCRU/costs in NMIBC, UC, SLE, PC, SCLC; and be used to develop economic models in NMIBC, UC, SLE, PC, SCLC.

CONCLUSIONS: Many PROPSPERO-registered SLR research questions could be answered using existing LSRs in LiveSLR®. LSR platform uptake would enable timely HTA SLR development with lower costs versus manual SLRs. For SLR questions that cannot be directly answered (e.g., for specific subpopulations), LSRs can be adapted in LiveSLR®.