Systematic reviews are essential in evidence-based practice, providing a comprehensive and critical assessment of existing research on a particular topic. However, traditional systematic reviews have a significant limitation: they can quickly become outdated as new research is published, and this is where the concept of “living systematic review” comes into play.

A living systematic review is a dynamic and ongoing process that continually updates the existing evidence base on a particular topic. It involves the regular and systematic search, appraisal, and synthesis of new studies as they are published. The goal is to provide up-to-date and accurate information on a topic, ensuring that practitioners have access to the most recent and relevant evidence.

One key benefit of living systematic reviews is that they address publication bias, a well-known problem in traditional systematic reviews. Publication bias occurs when studies with positive results are more likely to be published than studies with negative or inconclusive results. This problem can lead to overrepresenting positive results in the evidence base, resulting in incorrect or misleading conclusions. By regularly updating the evidence base, a living systematic review helps to mitigate this issue and provides a more accurate picture of the available evidence.

Another benefit of a living systematic review is that it can help address the issue of rapidly changing evidence. In many fields, new research is published at an increasingly rapid rate, and it can be difficult to keep up with the latest developments. With a living systematic review, practitioners can be confident that they are using the most up-to-date information and that they are not basing their practice on outdated evidence.

Living systematic reviews are not without their challenges, however. One of the biggest challenges is the need for ongoing resources and manpower to conduct the searches and appraisals. Living systematic reviews requires a commitment from both the researcher and the sponsor to ensure that the review remains up-to-date and relevant.

Despite these challenges, the potential benefits of living systematic reviews make it an attractive option for evidence-based practitioners. By providing up-to-date and comprehensive information, living systematic reviews can help practitioners make informed decisions and support the development of best practice guidelines.

Large language models, LLMs, also offer a potential solution to overcome the workload barriers living systematic reviews face for mainstream adoption. By leveraging LLMs for data extraction and screening from PDFs, we could drastically reduce the time it takes to keep a living systematic review alive. 

In conclusion, living systematic reviews represent a significant step forward in evidence-based practice. They offer a more accurate and up-to-date picture of the available evidence. By addressing the limitations of traditional systematic reviews, living systematic reviews can revolutionize how we use evidence to inform patient care.