27.05.2020
Scope, quality, and inclusivity of clinical guidelines produced early in the covid-19 pandemic: rapid review
Others Transversal
Dagens A et al
BMJ
Main result
Identification of 2,836 studies, of which 2,794 were excluded after screening. 42 were included with 18 specific to Covid-19.
Overall, the clinical guidelines lacked detail and covered only a narrow range of subjects. Most of them were based on WHO guidelines.
Recommendations vary for example regarding the use of antivirals, anti-inflammatories, ...etc
Overall quality was low, particularly in the areas of stakeholder involvement, applicability, and editorial independence.
The links between evidence and recommendations were limited.
The provisions described for at-risk groups such as pregnant women, children, or the elderly were minimal.
Overall, the clinical guidelines lacked detail and covered only a narrow range of subjects. Most of them were based on WHO guidelines.
Recommendations vary for example regarding the use of antivirals, anti-inflammatories, ...etc
Overall quality was low, particularly in the areas of stakeholder involvement, applicability, and editorial independence.
The links between evidence and recommendations were limited.
The provisions described for at-risk groups such as pregnant women, children, or the elderly were minimal.
Takeaways
Early clinical guidelines in the Covid-19 pandemic were methodologically weak and neglected vulnerable individuals.
Strength of evidence Weak
- Quick literature review.
- Selection bias for recommendations published outside of bibliographic databases, especially for those not in English.
- Some studies have been translated automatically, losing some nuances...
- The AGREE II tool used to assess the quality of studies is intended for non-emerging processes.
Objectives
Assess the availability, quality, and inclusiveness of clinical guidelines produced during the early stages of the Covid-19 pandemic.
Method
A quick review of the literature on Ovid Medline, Ovid Embase, Ovid Global Health, Scopus, Web of Science Core Collection, and the WHO Global Index Medicus, from the onset of the pandemic to 14 March 2020. Other studies have been identified in the grey literature.
Included were clinical guidelines for the management of Covid-19, MERS, and SARS produced by national or international scientific organizations, governmental or non-governmental organizations, in all languages. Only early versions of these guidelines were included.
One reviewer analyzed the title and abstract of all publications and another analyzed 10% of excluded studies for quality control.
The selected studies were read in their entirety independently and a third reviewer intervened in case of disagreement.
Quality was assessed according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II.
The quality and content of these guidelines for COVID-19 have also been compared with recent clinical guidelines for MERS or SARS.
Included were clinical guidelines for the management of Covid-19, MERS, and SARS produced by national or international scientific organizations, governmental or non-governmental organizations, in all languages. Only early versions of these guidelines were included.
One reviewer analyzed the title and abstract of all publications and another analyzed 10% of excluded studies for quality control.
The selected studies were read in their entirety independently and a third reviewer intervened in case of disagreement.
Quality was assessed according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II.
The quality and content of these guidelines for COVID-19 have also been compared with recent clinical guidelines for MERS or SARS.
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