OBJECTIVES: Living health technology assessment (HTA) and living systematic reviews (LSR) have gained increasing interest since the coronavirus disease 2019 pandemic. Given the rise in use of such methodology, this study aimed to identify best practice guidance and any associated challenges in conducting LSRs.

METHODS: A comprehensive literature review was conducted in January 2023 in Embase and MEDLINE (via Ovid). The websites of key organisations were also searched to identify papers reporting on best practice recommendations on LSR methodology. Studies were selected by a single reviewer. Included studies were extracted in a piloted template with data collected on each step of the LSR process, as well as any user experience on perceived challenges.

RESULTS: Common themes across the identified reports included the need for a protocol following existing reporting standards with adaptations to include pre-specification on which research questions require a living approach; the timing and frequency of updates; and adaptations to the analytic techniques and reporting to accommodate frequent updates. Searches were recommended to be broad and adaptive to consider changes in relevant interventions. Searches were recommended to occur following the release of publications from key congresses. Themes for optimisation of the LSR included online digital data extraction for automated presentation and visualisation of data. (Semi-) automation of tasks was consistently recommended to meet the timely demand of LSRs. Some challenges included resource implications of frequent updates, as well as re-thinking how to disseminate results as traditional methods such as peer-reviewed journals are less timely.

CONCLUSIONS: The need for LSRs is evident, however, alignment on methodology and reporting standards is required. Prior to a consensus on standards for LSRs, stakeholders (academia, industry, guideline development groups and HTA agencies) must agree on the suitability of using (semi-) automated tools to realise and maintain the demand of LSRs.