Article type
Abstract
Background
The Australian COVID-19 clinical guidelines, developed by the National Clinical Evidence Taskforce, represented a paradigmatic shift in living guideline development. The process utilized a dynamic yet robust approach to evidence identification, synthesis, and translation, along with streamlined methods for convening highly responsive panels and generating recommendations. As a result, the Taskforce produced more than 180 recommendations across 120 guideline updates within 40 months.
Objectives
To reflect on the strengths of the Taskforce’s approach to developing COVID-19 clinical guidelines and highlight areas of improvement to assist in the planning, production, and dissemination of high-priority living guidelines moving forward.
Methods
Prior to the COVID-19 pandemic, members of the Australian Living Evidence Collaboration employed living guideline methods in the development of stroke, diabetes, and arthritis guidelines, among others. In March 2020, this knowledge was applied to the Australian COVID-19 clinical guidelines, resulting in the rapid identification and assessment of evidence specific to the treatment of individuals with COVID-19 and development of related recommendations by panels comprising 34 peak National Health Organizations.
Results
The establishment of robust, high-throughput methods, along with daily evidence surveillance and iterative PICO development, ensured that all eligible trials were identified, analyzed, and used to support the development of recommendations within extremely short time frames. Broad stakeholder involvement and endorsement of the output, effective publication and dissemination, and production of decision aids and flow charts facilitated increased trust in the process and improved implementation of recommendations. Although there were significant strengths, there were also many areas for improvement, for example, greater international collaboration, early prioritization of recommendations, expansion of information relating to non–evidence-based evidence to decision factors, and closer early critiquing of potentially problematic studies.
Conclusions
The Australian COVID-19 clinical guidelines were groundbreaking in their adaptability and responsiveness to evidence and their ability to maintain high-currency recommendations. By retrospectively critiquing the strengths and weaknesses of the methods employed to develop these guidelines, future guidelines will be better placed to address high-priority areas of interest.
The Australian COVID-19 clinical guidelines, developed by the National Clinical Evidence Taskforce, represented a paradigmatic shift in living guideline development. The process utilized a dynamic yet robust approach to evidence identification, synthesis, and translation, along with streamlined methods for convening highly responsive panels and generating recommendations. As a result, the Taskforce produced more than 180 recommendations across 120 guideline updates within 40 months.
Objectives
To reflect on the strengths of the Taskforce’s approach to developing COVID-19 clinical guidelines and highlight areas of improvement to assist in the planning, production, and dissemination of high-priority living guidelines moving forward.
Methods
Prior to the COVID-19 pandemic, members of the Australian Living Evidence Collaboration employed living guideline methods in the development of stroke, diabetes, and arthritis guidelines, among others. In March 2020, this knowledge was applied to the Australian COVID-19 clinical guidelines, resulting in the rapid identification and assessment of evidence specific to the treatment of individuals with COVID-19 and development of related recommendations by panels comprising 34 peak National Health Organizations.
Results
The establishment of robust, high-throughput methods, along with daily evidence surveillance and iterative PICO development, ensured that all eligible trials were identified, analyzed, and used to support the development of recommendations within extremely short time frames. Broad stakeholder involvement and endorsement of the output, effective publication and dissemination, and production of decision aids and flow charts facilitated increased trust in the process and improved implementation of recommendations. Although there were significant strengths, there were also many areas for improvement, for example, greater international collaboration, early prioritization of recommendations, expansion of information relating to non–evidence-based evidence to decision factors, and closer early critiquing of potentially problematic studies.
Conclusions
The Australian COVID-19 clinical guidelines were groundbreaking in their adaptability and responsiveness to evidence and their ability to maintain high-currency recommendations. By retrospectively critiquing the strengths and weaknesses of the methods employed to develop these guidelines, future guidelines will be better placed to address high-priority areas of interest.