Case study 1: Ebola

First up, Ebola and Personal Protective Equipment: 

Question: What is the effectiveness of Personal Protective Equipment for healthcare workers caring for patients with Ebola?

Context

During the 2014 outbreak of Ebola in West Africa, the World Health Organization (WHO) commissioned researchers from the Ottawa Hospital Research Institute to conduct a rapid review on the effectiveness of personal protective equipment for healthcare workers caring for patients with Ebola to inform a Rapid Advice Guideline.

Approach taken

This was an interesting rapid review because there wasn’t a lot of existing evidence, but in light of the burgeoning Ebola epidemic, the WHO needed to make a decision as quickly as possible. The rapid review process was flexible and iterative and involved expanding the scope of the question and applying flexible screening criteria. The team therefore did not need to take as many shortcuts as most other rapid reviews do.

Findings

The review was conducted in 7 weeks (late July to August 2014) and led to updated WHO guidelines released in October of 2014. From 1,240 studies screened, 30 non-comparative studies were included. The researchers didn’t find a lot of relevant studies, and methods and reporting approaches among the studies they found weren’t that great. Overall, the review concluded that there was insufficient evidence to draw conclusions on the comparative effectiveness of various types of Personal Protective Equipment.

Action

In spite of limited evidence, the findings from this rapid review still fed into the WHO guideline and resulted in several recommendations for research. For example, knowledge gaps from this rapid review highlighted a need for comparative studies, better reporting for case reports and observational studies, and regular environmental scanning of in-progress studies.