LES spotlight

Innovations in evidence products and processes, such as living evidence syntheses (LES) and living guidelines, show that evidence producers can meet the constraints expected of decision-makers. These tools are of increasing interest as they not only summarize the best-available evidence on a topic but are also updated regularly as contexts, issues and evidence evolve, ensuring that decision-makers can quickly adapt their approaches. Updates can also include enhancements to scope (e.g., by expanding the outcomes included in the analysis) and methods (e.g., by incorporating risk of bias assessments and/or GRADE profiles) from previous versions of an LES. Moreover, LESs can produce and/or draw on open datasets such as a machine-learning mapping of global research on climate and health.

We have led or supported several living evidence syntheses. To view these you can:

• browse our living evidence syntheses
• review our suite of living evidence syntheses about public health and social measures to prevent respiratory infectious diseases
• access the protocol for our LES about addressing health-related misinformation
• access our new LES about effectiveness of doxycycline pre-exposure and post-exposure prophylaxis for preventing sexually transmitted infections

In addition, there are several relevant LESs produced by other teams that are worth highlighting. In an evidence profile of LESs that address public health topics and from scanning of other sources, we found five LESs addressing non-COVID topics:

• interventions for myopia control in children
• cannabis and other plant-based treatments for chronic pain
• adherence to guidelines in adult patients with traumatic brain injury
• clinical testing of the cardiovascular effects of e-cigarette substitution for smoking
• prevalence of mood and anxiety disorders and factors associated with symptoms in systemic sclerosis

We also identified several highly relevant COVID-19 LESs that were regularly updated, which focus on:

• effectiveness of the XBB.1.5 vaccine, and for adults, children and adolescents and over time
• effectiveness of seven public health and social measures (masks, quarantine and isolation, ventilation, physical distancing, reduction of contacts, hand hygiene and respiratory etiquette, cleaning, and disinfecting), as well as two LESs that examine combinations of and adherence to these measures, in preventing transmission of COVID-19 and other respiratory infectious diseases in non-health care community-based settings
• characterizing long COVID
• drug treatments for COVID-19
• prophylaxis against COVID-19
• economic evaluations of diagnostics and treatments of COVID-19
• convalescent plasma for people with COVID-19
• risk phenotypes of diabetes and association with COVID-19 severity and death
• effectiveness of COVID-19 vaccines against sars-cov-2 infection with the delta (b.1.617.2) variant

Additional examples of LESs that we have identified that are worth noting, include:

• efficacy outcomes for systemic immunomodulatory treatments for atopic dermatitis
• effectiveness of coronary CT angiography and standard of care for evaluating acute chest pain
• conservative and surgical modalities in the management of pediatric parapneumonic effusion and empyema
• effectiveness of exercise treatments with or without adjuncts for common lower limb tendinopathies
• pharmacological treatments for chronic plaque psoriasis

We welcome suggestions to forum@mcmaster.ca of LESs addressing other priority topics that we may not be aware of that we can profile here.