RT Journal Article
SR Electronic
T1 Which actionable statements qualify as good practice statements In Covid-19 guidelines? A systematic appraisal
JF BMJ Evidence-Based Medicine
JO BMJ EBM
FD BMJ Publishing Group Ltd
SP bmjebm-2021-111866
DO 10.1136/bmjebm-2021-111866
A1 Omar Dewidar
A1 Tamara Lotfi
A1 Miranda Langendam
A1 Elena Parmelli
A1 Zuleika Saz Parkinson
A1 Karla Solo
A1 Derek K Chu
A1 Joseph L Mathew
A1 Elie A Akl
A1 Romina Brignardello-Petersen
A1 Reem A Mustafa
A1 Lorenzo Moja
A1 Alfonso Iorio
A1 Yuan Chi
A1 Carlos Canelo-Aybar
A1 Tamara Kredo
A1 Justine Karpusheff
A1 Alexis F Turgeon
A1 Pablo Alonso-Coello
A1 Wojtek Wiercioch
A1 Annette Gerritsen
A1 Miloslav Klugar
A1 María Ximena Rojas
A1 Peter Tugwell
A1 Vivian Andrea Welch
A1 Kevin Pottie
A1 Zachary Munn
A1 Robby Nieuwlaat
A1 Nathan Ford
A1 Adrienne Stevens
A1 Joanne Khabsa
A1 Zil Nasir
A1 Grigorios I Leontiadis
A1 Joerg J Meerpohl
A1 Thomas Piggott
A1 Amir Qaseem
A1 Micayla Matthews
A1 Holger J Schünemann
A1 ,
YR 2022
UL http://ebm.bmj.com/content/early/2022/04/24/bmjebm-2021-111866.abstract
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.All data relevant to the study are included in the article or uploaded as online supplemental information. All relevant data included.