Which actionable statements qualify as good practice statements In Covid-19 guidelines? A systematic appraisal
Dewidar, Omar (School of Epidemiology and Public Health. University of Ottawa)
Lotfi, Tamara (Who Collaborating Center for Infectious Diseases. Research Methods and Recommendations. McMaster University)
Langendam, Miranda (Amsterdam University Medical Centers. University of Amsterdam)
Parmelli, Elena (Joint Research Centre. European Commission)
Saz Parkinson, Zuleika (Instituto de Salud Carlos Iii. Agencia de Evaluación de Tecnologías Sanitarias)
Solo, Karla (Who Collaborating Center for Infectious Diseases. Research Methods and Recommendations. McMaster University)
Chu, Derek K. (Department of Medicine. McMaster University)
Mathew, Joseph L. (Department of Pediatrics. Post Graduate Institute of Medical Education and Research)
Akl, Eli A. (Department of Internal Medicine. American University of Beirut)
Brignardello-Petersen, Romina (Michael G DeGroote Cochrane Canada and McMaster Grade Centres. McMaster University)
Mustafa, Reem A. (Internal Medicine. Division of Nephrology and Hypertension. University of Kansas School of Medicine)
Moja, Lorenzo (Department of Health Product Policy and Standards. World Health Organization)
Iorio, Alfonso (Department of Medicine. McMaster University)
Chi, Yuan (Cochrane Campbell Global Ageing Partnership)
Canelo Aybar, Carlos Gilberto (Institut d'Investigació Biomèdica Sant Pau)
Kredo, Tamara (Clinical Pharmacology. Department of Medicine. Stellenbosch University)
Karpusheff, Justine (National Institute for Health and Care Excellence)
Turgeon, Alexis F. (Department of Anesthesiology and Critical Care Medicine. Université Laval)
Alonso-Coello, Pablo (Institut d'Investigació Biomèdica Sant Pau)
Wiercioch, Wojtek (Who Collaborating Center for Infectious Diseases. Research Methods and Recommendations. McMaster University)
Gerritsen, Annette (Cochrane South Africa. South African Medical Research Council)
Klugar, Miloslav (Czech National Centre for Evidence-Based Healthcare and Knowledge Translation. Institute of Biostatistics and Analyses. Masaryk University)
Rojas-Reyes, Maria Ximena (Institut d'Investigació Biomèdica Sant Pau)
Tugwell, Peter (Clinical Epidemiology Program. Ottawa Hospital Research Institute)
Welch, Vivian (School of Epidemiology and Public Health. University of Ottawa)
Pottie, Kevin (Deparatment of Family Medicine. University of Ottawa)
Munn, Zachary (Joanna Briggs Institute. University of Adelaide)
Nieuwlaat, Robby (Department of Health Research Methods Evidence and Impact. McMaster University)
Ford, Nathan (Department of Hiv. Hepatitis and Sexually Transmitted Infections. World Health Organization)
Stevens, Adrienne (Michael G DeGroote Cochrane Canada and McMaster Grade Centres. McMaster University)
Khabsa, Joanne (Clinical Research Institute. American University of Beirut)
Nasir, Zil (Michael G DeGroote Cochrane Canada and McMaster Grade Centres. McMaster University)
Leontiadis, Grigorios I. (Department of Medicine. McMaster University)
Meerpohl, Joerg J. (Medical Center - University of Freiburg. Institute for Evidence in Medicine)
Piggott, Thomas (Who Collaborating Center for Infectious Diseases. Research Methods and Recommendations. McMaster University)
Qaseem, Amir (American College of Physicians)
Matthews, Micayla (McMaster University (Canadà))
Schünemann, Holger (Cochrane Canada)

Date:	2022
Abstract:	Objectives To evaluate the development and quality of actionable statements that qualify as good practice statements (GPS) reported in COVID-19 guidelines. Design and setting Systematic review. We searched MEDLINE, MedSci, China National Knowledge Infrastructure (CNKI), databases of Grading of Recommendations Assessment, Development and Evaluation (GRADE) Guidelines, NICE, WHO and Guidelines International Network (GIN) from March 2020 to September 2021. We included original or adapted recommendations addressing any COVID-19 topic. Main outcome measures We used GRADE Working Group criteria for assessing the appropriateness of issuing a GPS: (1) clear and actionable; (2) rationale necessitating the message for healthcare practice; (3) practicality of systematically searching for evidence; (4) likely net positive consequences from implementing the GPS and (5) clear link to the indirect evidence. We assessed guideline quality using the Appraisal of Guidelines for Research and Evaluation II tool. Results 253 guidelines from 44 professional societies issued 3726 actionable statements. We classified 2375 (64%) as GPS; of which 27 (1%) were labelled as GPS by guideline developers. 5 (19%) were labelled as GPS by their authors but did not meet GPS criteria. Of the 2375 GPS, 85% were clear and actionable; 59% provided a rationale necessitating the message for healthcare practice, 24% reported the net positive consequences from implementing the GPS. Systematic collection of evidence was deemed impractical for 13% of the GPS, and 39% explained the chain of indirect evidence supporting GPS development. 173/2375 (7. 3%) statements explicitly satisfied all five criteria. The guidelines' overall quality was poor regardless of the appropriateness of GPS development and labelling. Conclusions Statements that qualify as GPS are common in COVID-19 guidelines but are characterised by unclear designation and development processes, and methodological weaknesses.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	BMJ Evidence-Based Medicine, Vol. 27 Núm. 6 (April 2022) , p. 361-369, ISSN 2515-4478

DOI: 10.1136/bmjebm-2021-111866
PMID: 35428695

9 p, 1.2 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
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