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Clinical Practice Guidelines and Recommendations in the Context of the COVID-19 Pandemic: Systematic Review and Critical Appraisal

27 Pages Posted: 22 Jul 2020

See all articles by Tanja A. Stamm

Tanja A. Stamm

Medical University of Vienna - Section for Outcomes Research

Margaret R. Andrews

Medical University of Vienna - Section for Outcomes Research

Erika Mosor

Medical University of Vienna - Section for Outcomes Research

Valentin Ritschl

Medical University of Vienna - Section for Outcomes Research

Linda C. Li

University of British Columbia - Department of Physical Therapy

Jasmin K. Ma

University of British Columbia - Department of Physical Therapy

Adalberto Campo Arias

University of Magdalena - Faculty of Health Science

Sarah Baker

University of Sheffield - Unit of Oral Health

Nicola Burton

Griffith University - School of Applied Psychology

Mohammad Eghbali

University of Social Welfare and Rehabilitation Sciences - Department of Nursing

Natalia Fernandez

University of Michigan at Ann Arbor - Department of Physical Medicine and Rehabilitation

Ricardo Ferreira

Universidade de Coimbra - Centro Hospitalar

Gabriele Gäbler

Dietology Austria

Souzi Makri

The Cyprus League Against Rheumatism and Platform Organization for People for Rheumatic Diseases in Southern Europe

Sandra Mintz

Childrens Hospital Los Angeles

Rikke Moe

Diakonhjemmet Hospital - 3Department of Rheumatology

Elizabeth Morasso

UCLA Health System - Department of Radiation Oncology

Susan L. Murphy

University of Michigan at Ann Arbor - Department of Physical Medicine and Rehabilitation

Simiso Ntuli

University of Johannesburg - Department of Podiatry

Maisa Omara

Medical University of Vienna - Section for Outcomes Research

Miguel Angel Simancas Pallares

University of North Carolina at Chapel Hill - Division of Pediatric and Public Health

Jen Horonieff

Savvy Cooperative

Gerald Gartlehner

Danube University Krems - Department for Evidencebased Medicine and Evaluation

More...

Abstract

Background: The number of published clinical practice guidelines and recommendations related to SARS-CoV-2 infections causing COVID-19 has rapidly increased to address the need to deliver healthcare safely in the current pandemic. The aim of our study was to explore if basic methodological standards of guideline development have been met.

Methods: We conducted a rapid systematic review of guidelines published until April 27th, 2020 supervised by an international expert task force including representatives from each of the six WHO regions. At least two reviewers independently extracted guideline characteristics, conducted critical appraisal according to the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) and classified the guidelines using the Association of the Scientific Medical Societies (AWMF) Guidance Manual and Rules for Guideline Development.

Findings: There were 1342 titles screened and 188 guidelines included. The most frequent medical areas addressed were acute COVID-19 care (n=45; 24%), surgery (n=41; 22%), oncology (n=20; 11%), radiology (n=13; 7%) and cardiology (n=10; 6%). Patients were included in development of only one guideline. A process for regular updates was described in 27 guidelines (14%). The highest average AGREE II domain score was 89% for scope and purpose, the lowest for rigor of development (25%). Eight guidelines were based on a systematic literature search and structured consensus process by representative experts (classified as the highest methodological quality, S3 according to AWMF).

Conclusion: Despite clear scope, most publications fell short of basic methodological standards of guideline development. Guidelines should include up-to-date information, transparent stakeholder involvement and rigorous methodologies.

Funding Statement: This study was partly funded by the COVID19-Rapid Response Funding Scheme of the Wiener Wissenschafts-, Forschungs- und Technologiefonds (WWTF)/Vienna Science and Technology Fund (project number COV20-028). The funding institution had no influence on the results of this work.

Declaration of Interests: The authors declare no competing interests related to this work.

Keywords: Coronavirus, COVID-19, SARS CoV-2, Recommendations, Guidelines, Clinical practice guidelines

Suggested Citation

Stamm, Tanja A. and Andrews, Margaret R. and Mosor, Erika and Ritschl, Valentin and Li, Linda C. and Ma, Jasmin K. and Arias, Adalberto Campo and Baker, Sarah and Burton, Nicola and Eghbali, Mohammad and Fernandez, Natalia and Ferreira, Ricardo and Gäbler, Gabriele and Makri, Souzi and Mintz, Sandra and Moe, Rikke and Morasso, Elizabeth and Murphy, Susan L. and Ntuli, Simiso and Omara, Maisa and Simancas Pallares, Miguel Angel and Horonieff, Jen and Gartlehner, Gerald, Clinical Practice Guidelines and Recommendations in the Context of the COVID-19 Pandemic: Systematic Review and Critical Appraisal (6/3/2020). Available at SSRN: https://ssrn.com/abstract=3622355 or http://dx.doi.org/10.2139/ssrn.3622355

Tanja A. Stamm (Contact Author)

Medical University of Vienna - Section for Outcomes Research ( email )

Vienna
Austria

Margaret R. Andrews

Medical University of Vienna - Section for Outcomes Research

Vienna
Austria

Erika Mosor

Medical University of Vienna - Section for Outcomes Research

Vienna
Austria

Valentin Ritschl

Medical University of Vienna - Section for Outcomes Research

Vienna
Austria

Linda C. Li

University of British Columbia - Department of Physical Therapy

2329 West Mall
Vancouver, British Columbia BC V6T 1Z4
Canada

Jasmin K. Ma

University of British Columbia - Department of Physical Therapy

2329 West Mall
Vancouver, British Columbia BC V6T 1Z4
Canada

Adalberto Campo Arias

University of Magdalena - Faculty of Health Science

Santa Marta
Colombia

Sarah Baker

University of Sheffield - Unit of Oral Health

17 Mappin Street
Sheffield, Sheffield S1 4DT
United Kingdom

Nicola Burton

Griffith University - School of Applied Psychology

Gold Coast, Queensland 9726
Australia

Mohammad Eghbali

University of Social Welfare and Rehabilitation Sciences - Department of Nursing

Iran

Natalia Fernandez

University of Michigan at Ann Arbor - Department of Physical Medicine and Rehabilitation

Ann Arbor, MI 48103
United States

Ricardo Ferreira

Universidade de Coimbra - Centro Hospitalar

Praceta Dr. Mota Pinto
Coimbra, 3004-561
Portugal

Gabriele Gäbler

Dietology Austria

Vienna
Austria

Souzi Makri

The Cyprus League Against Rheumatism and Platform Organization for People for Rheumatic Diseases in Southern Europe

Cyprus

Sandra Mintz

Childrens Hospital Los Angeles

4650 Sunset Boulevard
Los Angeles, CA 90027
United States

Rikke Moe

Diakonhjemmet Hospital - 3Department of Rheumatology

Oslo
Norway

Elizabeth Morasso

UCLA Health System - Department of Radiation Oncology

10833 Le Conte Avenue
17-165 CHS
Los Angeles, CA 90095-1730
United States

Susan L. Murphy

University of Michigan at Ann Arbor - Department of Physical Medicine and Rehabilitation

Ann Arbor, MI 48103
United States

Simiso Ntuli

University of Johannesburg - Department of Podiatry

PO Box 524
Auckland Park
Johannesburg, Gauteng 2006
South Africa

Maisa Omara

Medical University of Vienna - Section for Outcomes Research

Vienna
Austria

Miguel Angel Simancas Pallares

University of North Carolina at Chapel Hill - Division of Pediatric and Public Health

102 Ridge Road
Chapel Hill, NC NC 27514
United States

Jen Horonieff

Savvy Cooperative

Queens, NY
United States

Gerald Gartlehner

Danube University Krems - Department for Evidencebased Medicine and Evaluation

Krems a.d. Donau
Austria

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