Systematic Review Update Decision Brief

Produce a Systematic Review Update Decision Brief that determines whether the existing review should be updated now, deferred, monitored, or amended with a bounded scope.

Do not redo initial screening, extraction, or full evidence synthesis unless the update decision cannot be made without a narrowly defined check. Focus on update triggers, conclusion stability, and the minimum defensible update scope.

Inputs:
- Review title and citation: [Review title and citation]
- Review question or PICO: [Review question or PICO]
- Original search end date: [Original search end date]
- Original conclusions and certainty ratings: [Original conclusions and certainty ratings]
- Surveillance sources and date range: [Surveillance sources and date range]
- Current decision need: [Current decision need]
- Known methodological or data issues: [Known methodological or data issues]

Evidence discipline:
- Separate observed evidence from inference.
- Cite sources for every factual claim about new studies, retractions, corrections, guidelines, methods changes, or decision context.
- State the date accessed for web sources when available.
- If a source is mentioned but not accessible, mark it as “not inspected” and do not rely on it as evidence.
- Do not claim that searches, screening, extraction, statistical checks, author contact, or protocol approval were completed unless the supplied evidence supports that claim.
- Identify missing information that could materially change the decision.
- Preserve uncertainty where evidence is incomplete or surveillance is limited.

Decision criteria:
Assess whether any of the following update triggers are present:
1. New eligible studies plausibly change effect direction, effect size, precision, heterogeneity, applicability, or certainty.
2. New evidence affects outcomes prioritized for the current decision need.
3. New safety, equity, subgroup, implementation, cost, or long-term outcome evidence changes practical interpretation.
4. Retractions, expressions of concern, corrected data, duplicate publications, or serious integrity concerns affect included or influential studies.
5. Changes in methods, risk-of-bias expectations, outcome standards, reporting norms, or certainty assessment make the original conclusions unreliable for current use.
6. New guidelines, regulatory decisions, policy needs, payer decisions, or clinical practice changes create a time-sensitive decision requirement.
7. The original review has become stale because the evidence base, intervention, comparator, population, or context has materially changed.

Deliverable format:

1. Decision Snapshot
- Existing review: cite the review.
- Original evidence currency: state the original search end date.
- Current decision need: summarize the decision the update must support.
- Recommended decision: choose one: No update needed now; Continue surveillance; Focused update; Full update; Protocol amendment before update; Defer because evidence is insufficient or inaccessible.
- Confidence in decision: High / Moderate / Low, with a short reason.
- Accountable verification owner: name the role that should verify the decision, such as review lead, methods lead, clinical content owner, guideline chair, research director, or data owner.

2. Surveillance Evidence Log
Create a table with these columns:
- Evidence item
- Source and citation
- Date range or publication date
- Why it may matter
- Status: observed / inferred / not inspected
- Link to original review question or PICO
- Potential update trigger
- Limitations or uncertainty

Include new studies, trial registrations, preprints when relevant, retractions, corrections, expressions of concern, updated guidelines, methodological changes, and decision-context changes. Do not include marginal items unless they could affect the update decision.

3. New-Evidence Impact Matrix
Create a matrix with these rows where applicable:
- Population
- Intervention or exposure
- Comparator
- Primary outcomes
- Harms or safety outcomes
- Equity or subgroup effects
- Certainty of evidence
- Risk of bias or study integrity
- Applicability to the current decision need
- Methods or reporting expectations

For each row, provide:
- New or changed evidence observed
- Likely impact on original conclusion: none / minor / moderate / major / unknown
- Basis for judgment
- What would need to be checked in a formal update

4. Conclusion-Stability Assessment
For each major original conclusion, assess:
- Original conclusion and certainty rating
- New evidence or issue relevant to that conclusion
- Whether the conclusion is likely stable, possibly unstable, likely unstable, or cannot be assessed
- Reasoning, distinguishing evidence from inference
- Consequence if the conclusion changed

5. Update Trigger Decision
State whether the threshold for an update is met. Use this structure:
- Trigger status: met / not met / unclear
- Triggering evidence or issue
- Decision risk if no update is performed
- Decision risk if an update is performed too broadly
- Recommended update type and scope
- Explicit exclusions from the update scope
- Minimum evidence checks required before work begins

6. Bounded Update Scope
Define the smallest responsible update scope:
- Review question or PICO elements to retain unchanged
- Elements to amend, if any
- Outcomes to prioritize
- Study designs to include or exclude
- Date range to search
- Databases, registries, and targeted sources to search
- Whether re-screening of prior included studies is needed and why
- Whether reanalysis is likely needed and why
- Whether certainty assessment must be revised
- Known exclusions that prevent scope creep

7. Protocol Amendment and Work Plan
If any update or amendment is recommended, draft a practical work plan:
- Required protocol amendments
- Review team roles: review lead, information specialist, methods lead, content reviewer, statistician if needed, and data owner if corrected data are involved
- Priority tasks in sequence
- Evidence checks before extraction or synthesis
- Estimated level of effort: low / medium / high, with rationale
- Decision points where the update may be narrowed, expanded, paused, or stopped
- Approval or sign-off needed from the accountable review, guideline, policy, or research owner

If no update is recommended, provide a surveillance plan instead:
- Conditions that would trigger reconsideration
- Sources to monitor
- Suggested surveillance interval
- Owner responsible for monitoring

8. Missing Information and Verification Checks
List only missing information that could materially alter the update decision. Then provide completion checks:
- Are all relied-upon sources cited?
- Are inaccessible sources clearly marked as not inspected?
- Are observations separated from inference?
- Is the update decision tied to explicit triggers?
- Is the recommended scope bounded enough to prevent unnecessary full-review work?
- Is owner verification clearly assigned?

Keep the brief practical, evidence-bound, and suitable for review lead or policy owner decision-making. Avoid generic literature-summary prose.