TY - JOUR
T1 - Which actionable statements qualify as good practice statements In Covid-19 guidelines? A systematic appraisal
AU - Dewidar, Omar
AU - Lotfi, Tamara
AU - Langendam, Miranda
AU - Parmelli, Elena
AU - Saz Parkinson, Zuleika
AU - Solo, Karla
AU - Chu, Derek K.
AU - Mathew, Joseph L.
AU - Akl, Elie A.
AU - Brignardello-Petersen, Romina
AU - Mustafa, Reem A.
AU - Moja, Lorenzo
AU - Iorio, Alfonso
AU - Chi, Yuan
AU - Canelo-Aybar, Carlos
AU - Kredo, Tamara
AU - Karpusheff, Justine
AU - Turgeon, Alexis F.
AU - Alonso-Coello, Pablo
AU - Wiercioch, Wojtek
AU - Gerritsen, Annette
AU - Klugar, Miloslav
AU - Rojas, María Ximena
AU - Tugwell, Peter
AU - Welch, Vivian Andrea
AU - Pottie, Kevin
AU - Munn, Zachary
AU - Nieuwlaat, Robby
AU - Ford, Nathan
AU - Stevens, Adrienne
AU - Khabsa, Joanne
AU - Nasir, Zil
AU - Leontiadis, Grigorios I.
AU - Meerpohl, Joerg J.
AU - Piggott, Thomas
AU - Qaseem, Amir
AU - Matthews, Micayla
AU - Schünemann, Holger J.
N1 - Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.
PY - 2022/4/15
Y1 - 2022/4/15
N2 - 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.
AB - 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.
KW - COVID-19
KW - Evidence-Based Practice
KW - Health Services Research
UR - https://www.scopus.com/pages/publications/85128882586
U2 - 10.1136/bmjebm-2021-111866
DO - 10.1136/bmjebm-2021-111866
M3 - Article
C2 - 35428695
AN - SCOPUS:85128882586
SN - 2515-446X
VL - 27
SP - 361
EP - 369
JO - BMJ Evidence-Based Medicine
JF - BMJ Evidence-Based Medicine
IS - 6
ER -