Article type
Abstract
Introduction
We developed a framework to characterize actionable statements in guidelines. These actionable statements are formal recommendations, good practice statements (GPSs), research-only recommendations, implementation considerations, tools and tips, and informal recommendations. Informal recommendations are not supported by evidence and did not result from a formal development process.
Objectives
To apply the framework for actionable statements and explore the association between the quality of guidelines and the type of actionable statements they include
Methods
We systematically searched for and screened COVID-19 guidelines published between 2020 and 2023 without language restriction. We appraised in duplicate each guideline using the AGREE II tool and calculated a score for each of the 6 AGREE II domains. We applied our framework to identify the type and proportion of actionable statements in each guideline. We explored the characteristics of the guidelines (source organization, grading methodology, providing evidence-to-decision tables [EtD], rapid, living), and evaluated the association between proportions of formal recommendations, GPSs, and informal recommendations and the scores per AGREE II domain.
Results
We captured 1218 COVID-19 guidelines. Fifty-five per cent of these were updates of guidelines. A minority were rapid (95.0%) or living (90.2%) guidelines. Most of the guidelines (89.0%) did not apply a grading system for certainty of evidence, 9.4% used GRADE, and 1.6% used another system. A minority (5.3%) provided EtDs. The highest proportion of actionable statements in these guidelines were informal recommendations with a mean (and SD) of 71.1% (42%).
The difference between means of proportions of formal and informal recommendations, and that of GPSs and informal recommendations, was significant at a level of 0.01. We found a moderate negative correlation between the proportion of informal recommendations and the domains of AGREE II.
Conclusion
The quality of COVID-19 guidelines is correlated with the type of actionable statements they included.
Public involvement statement
This is a secondary data analysis and the public and/or consumers were not involved in the study.
We developed a framework to characterize actionable statements in guidelines. These actionable statements are formal recommendations, good practice statements (GPSs), research-only recommendations, implementation considerations, tools and tips, and informal recommendations. Informal recommendations are not supported by evidence and did not result from a formal development process.
Objectives
To apply the framework for actionable statements and explore the association between the quality of guidelines and the type of actionable statements they include
Methods
We systematically searched for and screened COVID-19 guidelines published between 2020 and 2023 without language restriction. We appraised in duplicate each guideline using the AGREE II tool and calculated a score for each of the 6 AGREE II domains. We applied our framework to identify the type and proportion of actionable statements in each guideline. We explored the characteristics of the guidelines (source organization, grading methodology, providing evidence-to-decision tables [EtD], rapid, living), and evaluated the association between proportions of formal recommendations, GPSs, and informal recommendations and the scores per AGREE II domain.
Results
We captured 1218 COVID-19 guidelines. Fifty-five per cent of these were updates of guidelines. A minority were rapid (95.0%) or living (90.2%) guidelines. Most of the guidelines (89.0%) did not apply a grading system for certainty of evidence, 9.4% used GRADE, and 1.6% used another system. A minority (5.3%) provided EtDs. The highest proportion of actionable statements in these guidelines were informal recommendations with a mean (and SD) of 71.1% (42%).
The difference between means of proportions of formal and informal recommendations, and that of GPSs and informal recommendations, was significant at a level of 0.01. We found a moderate negative correlation between the proportion of informal recommendations and the domains of AGREE II.
Conclusion
The quality of COVID-19 guidelines is correlated with the type of actionable statements they included.
Public involvement statement
This is a secondary data analysis and the public and/or consumers were not involved in the study.