Case study

Centre for Reviews and Dissemination (CRD)

Quality assessed systematic reviews of health and social care interventions


The Centre for Reviews and Dissemination (CRD) is based at the University of York and is part of the National Institute for Health Research (NIHR). It provides research-based information on the effects of health and social care interventions. Using its databases and undertaking systematic reviews CRD evaluates research evidence on health and public health questions of national and international importance.

CRD’s research findings are widely circulated, well respected and have impacted health care policy and practice in the UK and abroad.

CRD’s databases are:

  • The Database of Abstracts of Reviews of Effects (DARE)
  • NHS Economic Evaluation Database (NHS EED)
  • Health Technology Assessments (HTA)
  • International prospective register of systematic reviews (PROSPERO)

DARE comprises systematic reviews that evaluate the effects of health and social care interventions and the delivery and organisation of health and social care services. These reviews also include housing, transport and other factors that impact directly or have the potential to impact on health and wellbeing.

NHS EED comprises economic evaluations of health and social care interventions comparing the costs and outcomes using cost-benefit, cost-utility or cost-effectiveness analyses.

HTA includes completed and ongoing health technology assessments from around the world. It is a valuable source for identifying grey literature – information available only from individual funding agencies.

PROSPERO (see separate case study) is a prospective register of systematic reviews with health-related outcomes and it is helping to increase the value and reduce the waste of finite resources in biomedical research. 

Overall objectives of CRD

CRD’s core objectives all relate to the evaluation of research evidence that informs decision making in health and social care. In broad terms CRD aims to:

  • Develop and maintain four databases of research evidence – DARE, NHS EED, HTA and PROSPERO
  • Inform policy, practice and further research using evidence synthesis
  • Provide information, advice, guidance to decision-making organisations
  • Develop expertise and capacity in systematic reviews via training, mentoring and promotion of evidence synthesis

The role of Metaxis

To create a bespoke content management solution to manage the searching, import, deduplication and categorisation of records. To make the solution easy to use via a dynamic, accessible, and reliable user interface and to keep the databases current by marshalling regular and sensitive searches for information from data sources such as MEDLINE, EMBASE, CINAHL, PsycINFO and PubMED.

The solution includes a sophisticated management process for methodologically sound data extraction and deduplication of data. This process lies at the core of the solution. Sensitive search strategies are used to find the most complete results and to minimise multiple reporting of the same data which could potentially lead to biased results. All assessments and all data are dual-extracted with each person blind to the other’s work, conflicts are resolved and every action is logged for a complete audit trail. The software manages allocation of work to the most appropriate person and controls the flow of records through the system to ensure the most efficient workflow.

Another key component of the solution is the inter-library loans module specifically developed for CRD to streamline the process of ordering documents from vast stores of information – over 42 million journal articles and other resources. By integrating with the British Library API, Metaxis automated the entire process from order placement, tracking, management and delivery of documents, removing the drudgery and saving CRD thousands of hours of time that could be deployed elsewhere.

Integrity, maintenance and updates are key to the success of these databases and enable the search and collation of reliable and thorough research evidence. Compiling the data has enabled thousands of citations to be assessed by CRD.

This project commenced in 1994 and new records were added until March 2015. There are approximately 35,000 quality assessed systematic reviews, summaries of all Cochrane systematic reviews and protocols up to March 2015, plus 17,000 economic evaluations and over 15,000 summaries of completed or ongoing HTAs available across these databases.

DARE, NHS EED are maintained as archives but still accessible and HTA continues to be updated regularly. These databases provide a valuable resource to those wishing to find out if reviews and economic evaluations have already been done together with related critical reviews and bottom line statements.

Key features:

  • Bespoke development of content management solution and front-end web sites
  • Intuitive, comprehensive and easy to use
  • Sophisticated search interfaces enabling fast and targeted access to the right data
  • Maximised data integrity and redundancy
  • Strong domain knowledge and content awareness aiding reliable data-deduplication

Key benefits:

  • Valuable resource of reviews and economic evaluations including critical reviews
  • Faster access to research evidence
  • Enables enhanced evidence synthesis due to high quality data integrity
  • Improved public health due to better informed decision-making based on reliable evidence

About Metaxis Ltd

Metaxis is a software development company based in the UK specialising in content management solutions and workflow control software. Our solutions support digital collaborative working environments where multiple users, regardless of their global location, can access and interact with high quality, relevant data and information in a meaningful and productive way.

Metaxis provides bespoke solutions rooted in best practice Agile methodology. Its software design principles – rapid behaviour-driven development, high performance, close client collaboration and ease of use – underpin the company’s business ethos.  Metaxis makes short work of Big Data.

Metaxis Ltd, Elmbank Court, Main Road, Curbridge, Witney OX29 7NT, UK Tel: +44 (0)1993 771740