Protocol for a rapid evidence review of traditional and complementary medicine for people with diabetes receiving palliative or end-of-life care

Background: Rapid review methods are increasingly used as an alternative to systematic reviews when there is time, resource or other logistical constraints. The Cochrane Rapid Reviews Methods Group recommends further methodological development and publishing protocols to improve the transparency and quality of the review. The authors of this paper were invited to provide timely, expert input for the revision of the 2010 Guidelines for Providing Palliative and End of Life Care for People with Diabetes (Guidelines), Australia, regarding the evidence-based use of traditional and complementary medicine (T&CM). The inclusion and consideration of T&CM in guidelines is often ad-hoc and would benefit from more systematic methods. Evidence of efficacy on clinical outcomes is not the only reason to review an intervention. Other reasons relevant to the T&CM context is: interventions that are commonly used by people with diabetes in the palliative care setting, have potentially high costs or risks, or present a conflict in choices between individual and societal perspectives. Method: The aim this review is to rapidly identify and synthesise the highest quality evidence about the safety and efficacy of a selection of T&CM interventions and provide timely information to update the Guidelines. The review has two stages 1) a rapid scoping review to inform the framing of the review questions and identify important modifying factors and 2) a rapid evidence review of up to 20 T&CM interventions to inform the Guidelines. Project constraints include limiting the number of interventions for appraisal and databases to be searched, and including only papers published in English. Searches and evidence appraisals will be conducted by single reviewers, with one tenth to be checked by another reviewer. No meta-analyses or modelling will be undertaken. Discussion: The proposed rapid review protocol is designed to address the time and resource constraints of the Guidelines developers, and inform rapid review methodology. Notwithstanding the methodological constraints, the proposed protocol and its reporting will be transparent, systematic and reproducible.