Background: Croup and acute gastroenteritis (AGE) are two of the most common pediatric illnesses; both are marked by high emergency department utilization and clinical practice variation. We implemented living systematic review (LSR) methodology to determine up-to-date evidence in these fields and to inform the development of knowledge translation tools for health consumers.
Objectives: To monitor emerging evidence on intervention efficacy for pediatric croup and AGE.
Methods: A research librarian comprehensively searched four databases at three-month intervals from September 2014 to March 2016 to update systematic reviews on interventions for croup (n = 4) and AGE (n = 4). Using Covidence, two independent reviewers completed primary and secondary screening (using predetermined criteria), quality assessment (using the Cochrane 'Risk of bias' tool), and data extraction. Primary and secondary outcomes were meta-analyzed by pooling the new data with previously published meta-analyses.
Results: For croup, one study (n = 174 participants) out of 163 studies,was included and contributed to a systematic review that originally contained eight studies (n = 225 participants). The study contributed to the primary outcome, but none of the secondary outcomes. There was no change in results; the primary outcome remained statistically significant. For AGE, one study (n = 123 participants) out of 776 studies was included and contributed to a systematic review that originally contained six studies (n = 1170 participants). The study contributed to the primary and all three secondary outcomes. There was no change in results; all outcomes remained non-significant. We identified three relevant studies that did not assess any outcomes of interest.
Conclusions: LSRs are a promising new approach to updating systematic reviews; however, over the course of 18 months, we found little additional evidence with no substantial changes in results. The optimal time intervals for running searches in LSRs will likely vary for different clinical fields. Additional case studies will help define methods in the emerging area of LSRs.