How To Do A Rapid Review In Medicine | Fast, Rigorous, Ready

What A Rapid Review Is

A rapid review is a condensed evidence synthesis that follows the logic of a systematic review, but with deliberate, transparent streamlining. Common choices include a tighter question, fewer databases, date or language limits, single-reviewer screening with verification, and focused synthesis. Timeframes range from two to eight weeks for many clinical or service questions. When trade-offs are declared up front and tracked in the report, users get speed without losing trust.

When A Rapid Review Fits The Task

Use this format when a decision has a near-term deadline, the question is specific, and the likely body of evidence is not enormous. It is also a strong fit for triage: map the field quickly, answer the core decision, and flag where a full review or an update would add value later. When stakes are high and the evidence base is sprawling, a full review may still be the safer route.

Doing A Rapid Review In Medicine: Core Workflow

The steps below mirror a full review, just with tighter scope and leaner execution. Each step notes common streamlining options that keep bias in check.

Step 1 — Frame A Sharp Question

Write a single, decision-anchored question using PICO (Population, Intervention, Comparator, Outcomes) or an equivalent structure. Name one primary outcome that maps to the decision. List a short set of secondary outcomes. Define setting, care level, and time horizon. Add explicit exclusion rules now, not later.

Step 2 — Co-Produce A Mini-Protocol

Draft a two-to-four page protocol. Include the question, inclusion criteria, search plan, screening approach, data items, bias tools, and synthesis plan. Note every planned shortcut and the reason for it. Share with the requester for sign-off. Post to an open repository if you can. Even a brief, time-stamped plan reduces mid-project drift.

Step 3 — Design A Targeted Search

Pick two to four databases that best cover the area (for many clinical topics, MEDLINE and Embase form the core; add CENTRAL or CINAHL as needed). Write a compact strategy built from the question terms, exploded subject headings, and tested keywords. Pilot, then lock. Save exact strategies for the appendix. If time allows, add citation tracking from seed papers and recent guidelines.

Step 4 — Screen Fast, Check Often

Use dual screening on a 10–20% calibration set to align judgments. Once agreement is solid, switch to single-reviewer title/abstract screening with second-reviewer verification on all exclusions at full text or on a random sample. Record numbers for a PRISMA-style flow diagram.

Step 5 — Extract Lean, Relevant Data

Build a short form that captures only what flows into the planned synthesis: study design, population, setting, intervention/comparator, follow-up, outcome metrics, and key effect data. One reviewer extracts; a second checks critical fields (effect numbers, units, time points). Keep a change log.

Step 6 — Assess Risk Of Bias

Pick tools matched to study design (RoB 2 for randomized trials, ROBINS-I for non-randomized studies). Apply a two-tier approach: full dual ratings on the primary outcome, single plus check on others. Summarize judgments by domain and at study level with short justifications.

Step 7 — Synthesize With A Plan

If studies are similar in design, populations, and measures, run a random-effects meta-analysis. If heterogeneity blocks pooling, use structured narrative with effect sizes and direction of effect laid out in a consistent template. Pre-specify one or two sensible subgroup or sensitivity checks, and avoid data dredging.

Step 8 — Rate Certainty And Draft Messages

Use a brief GRADE workflow for each main outcome: start at high for randomized trials (lower for non-randomized), then judge risk of bias, inconsistency, indirectness, imprecision, and publication bias. End with clear statements: what works, for whom, and with what confidence.

Step 9 — Write For Decisions

Lead with a one-page summary: question, short methods note, main findings, certainty, and practical takeaways. Place methods details, full search strings, bias tables, and extra analyses in appendices. Keep the body tight and skimmable with brief headed sections.

Rapid Review Shortcuts And Safeguards

The table lists common time-savers and the matching guardrails that keep results dependable. Pick only those that suit your question and document each one.

Search Strategy That Works When Time Is Short

Pick Sources With Intent

Map the question to coverage. Drug and device trials lean on MEDLINE and Embase; rehabilitation or nursing often benefits from CINAHL; surgery can need specialized indexes. For effectiveness, CENTRAL adds trial records. Keep a short, justified list and state exact platforms used.

Build A Compact Strategy

Start from your PICO terms, explode subject headings, and add core synonyms. Keep noise low with proximity operators where supported. Run a quick sensitivity check against known trials. Save searches and export counts to the log. Add backward and forward citation tracking on the top studies to catch near-misses.

Handle Grey Literature Wisely

Scan recent guidelines and health agency pages that matter to the topic. Record sites visited and date checked. If time runs out, state which sources were left for a later sweep and why.

Screening And Study Selection

Calibrate, Then Streamline

Before full screening, two reviewers test a batch of titles and abstracts and agree on rules for edge cases. Once agreement is solid, one reviewer screens the rest, with checks at full text. Keep reasons for exclusion crisp and reusable so the PRISMA-style diagram is easy to build.

Manage Full-Text Bottlenecks

Request missing PDFs early. When access fails, email the authors while you continue with what you have. If a key study remains missing, note it in limitations and, if possible, extract from high-quality abstracts with a flag.

Data Extraction That Stays Lean

Only What You Need

Collect items that feed your synthesis and GRADE judgments. Typical fields: study ID, design, setting, eligibility, intervention and comparator details, time points, outcomes, effect metrics, and any adjustments. Use controlled lists for outcomes and time frames so tables line up cleanly.

Keep A Clean Audit Trail

Store extraction forms, raw exports, and calculation sheets in a shared folder with version control. Label each change with a date and initials. Small habits like this save rework when a query comes in late.

Risk Of Bias And Certainty

Match Tools To Designs

Trials use RoB 2. Cohorts or case-control studies use ROBINS-I. Summarize domain judgments in a compact table and explain any “some concerns” or “serious” calls in one or two lines. Then rate certainty by outcome with a short GRADE table that shows the reasons for any downgrades.

Report Certainty With Plain Text

Pair numbers with short, direct messages. Example style: “High-dose regimen reduced severe flares over 12 months (RR 0.72, 95% CI 0.60–0.86; moderate certainty).” The bracketed note tells readers how much trust to place in that number.

How To Conduct A Rapid Review In Healthcare Settings: People And Roles

Even a small team can move quickly with clear roles. A lead methodologist owns the protocol. An information specialist builds and runs searches. Two content reviewers handle calibration and tough calls. A statistician reviews models and data inputs. One writer shapes the summary and keeps language consistent across sections.

Engage The Requester

Hold a 30–45 minute kickoff to lock the question and exclusions. Share a one-page plan and agree on deadlines. Mid-project, run a short checkpoint to confirm scope and share any early signals from the data. This keeps the final output aligned with real-world decisions.

From Numbers To A Decision-Ready Story

Pool When It Makes Sense

When designs, measures, and follow-up match, pooling adds clarity. Pick a random-effects model, report heterogeneity, and show study weights. If pooling would mislead, stick to structured narrative and present consistent effect metrics across studies with short notes on context.

Present What Matters First

Open with a one-page brief. Lead with the question, the bottom-line effect on the primary outcome, the certainty rating, and any safety signals. Then add the two or three details that most influence action: baseline risk, absolute differences, and time frames. Everything else can sit behind a link or in appendices.

Second Table — Synthesis Choices At Speed

Choose methods that respect the data you have. This table lines up fast choices with their best use-cases.

Transparent Reporting

Document Every Choice

Include a short methods page in the report with the question, inclusion rules, databases and platforms, full search strings, screening process, bias tools, synthesis model, and any shortcuts. Add a PRISMA-style flow diagram and a brief limitations list that links each shortcut to a possible effect on findings.

Use Established Reporting Guides

Follow the spirit of PRISMA for structure and flow. Even a rapid review benefits from a clear checklist, a clean diagram, and reproducible search text. That small effort improves credibility and speeds peer checks.

Timeboxes, Deliverables, And A Simple Plan

A Four-Week Template (Tight Timeline)

Week 1: kickoff, protocol, search build, and pilots. Week 2: database runs, citation tracking, and title/abstract screening. Week 3: full-text screening, extraction, and initial bias ratings. Week 4: synthesis, GRADE, write-up, and requester briefing. Keep one spare day for fixes.

A Six-To-Eight-Week Template (More Air)

Add dual screening on full texts, broader grey literature, a second sensitivity analysis, and a short clinician review of the summary. This window suits topics with mixed designs or outcomes.

Limitations You Should Call Out

Speed introduces trade-offs: smaller source coverage, more single-reviewer steps, and fewer sensitivity checks. Name each one and link it to a practical effect. If language or date limits were used, state how many studies those rules might have excluded. If the body of evidence is thin or inconsistent, steer readers to where a full review would change certainty.

Aftercare: Keep The Review Useful

Plan For An Update

Set a reminder to rerun the search in six to twelve months, or sooner if a practice-changing trial appears. Keep the extraction form and analysis code ready so an update is a small lift, not a rebuild.

Share The Work

Publish search strategies, bias tables, and data files alongside the report. Clear materials help external readers trust the process and reuse your groundwork for local pathways, education, or service design.

Trusted Methods You Can Cite

For rapid-method choices and updated standards, see the Cochrane Rapid Reviews guidance in the BMJ (updated recommendations). For a hands-on manual that suits policy and service questions, the World Health Organization has a practical guide (rapid reviews guide). For reporting structure and flow diagrams, align with PRISMA 2020.

Final Checks Before Submission

One-Page Summary

Does the first page answer the question, show the main effect with units and time frame, and state certainty? If a busy reader skims only that page, will they know what to do next?

Methods At A Glance

Is every shortcut declared? Are search strings and dates present? Are bias tools named and applied to the primary outcome at a minimum?

Tables That Carry The Weight

Do evidence tables line up on outcomes and time points? Are effect sizes comparable across studies? Are absolute effects shown where they matter?

Language That Respects The Data

Does each claim link back to numbers and certainty? Are words like “may,” “probably,” and “confidently” used in line with the GRADE call? Consistency here builds trust.

Delivery Plan

Is the slide brief ready? Are appendices attached? Is there a plan for a quick huddle with the requester to walk through findings and limits?