Accelerated Parallelised Realist-Informed Literature Review (APRIL): A Novel Method for Informing Policy Decision-Making in Accelerated (<1 Month) Timescales

Policymakers and regulators often commission researchers to provide evidence to help understand potential policy changes and their implications. Rapid evidence appraisal is critical to informing policy making in situations where there are urgent or unexpected changes i.e. those that are not the result of long-term planning but are instead responding to events or crises. These approaches often mean that answers are desired within timeframes typically seen as unworkable by academics. We report a novel rapid realist synthesis method, originally devised for delivering a realist review in an under one-month timeframe for Care Quality Commission (a health and adult social care regulator in England). Key considerations were the need to maintain rigour and transparency whilst working at speed. The method comprises a nine-step process: (1) Setting up an expert panel; (2) reverse engineering research questions from policymaker priorities; (3) formulating a data extraction template; (4) sense-checking the strategy and focus areas with the funder and expert panel (5); building a systematic search strategy and running the searches; (6) performing screening, relevance and rigour assessment, and data extraction in parallel; (7) data synthesis and theory generation; (8) sense-checking initial findings with funder(s) and expert panel; and (9) report writing and dissemination. This method achieves its rapidity due to making use of parallelised review processes and adaptations to traditional methods, such as highly purposive but still systematic literature searching and theory-informed data extraction. It also relies on an engaged team with methodological and subject matter expertise who are ready to use collaborative technology to deliver on time. This method should be further tested for answering different research questions in different settings, for hypothesis generation, for diagnosing issues in clinical trials, and for use in rapid evaluation centres or by independent consultants.