From SARS and MERS to COVID-19: a review of the quality and responsiveness of clinical management guidelines in outbreak settings

作者：Samuel Lipworth, Ishmeala Rigby, Vincent Cheng, Peter Bannister, Eli Harriss, Karen Cook, Erhui Cai, Mais Tattan, Terrence Epie, Lakshmi Manoharan, Kate Lambe, Melina Michelen, Anna Vila Gilibets, Andrew Dagens, Louise Sigfrid, Peter Horby · 发表于：medRxiv · 年份：2021 · DOI：10.1101/2021.01.12.21249654 · 被引用次数：2 · 研究领域：Health Systems, Economic Evaluations, Quality of Life、Clinical practice guidelines implementation、Healthcare cost, quality, practices

Abstract Objective To assess the responsiveness and quality of clinical management guidelines (CMGs) in SARS, MERS and COVID-19 and determine whether this has improved over time. Design Rapid literature review, quality assessment and focus group consultation. Data Sources – Google and Google Scholar were systematically searched from inception to 6 th June 2020.This was supplemented with hand searches of national and international public health agency and infectious disease society websites as well as directly approaching clinical networks in regions where few CMGs had been identified via the primary search. Eligibility Criteria CMGs for the treatment of COVID-19/SARS/MERS providing recommendations on supportive care and/or specific treatment. Methods Data extraction was performed using a standardised form. The Appraisal of Guidelines for Research and Evaluation (AGREE-II) tool was used to evaluate the quality of the CMGs. Six COVID-19 treatments were selected to assess the responsiveness of a subset of guidelines and their updates to 20 th November 2020. We ran two sessions of focus groups with patient advocates to elicit their views on guideline development. Results We included 37 COVID-19, six SARS, and four MERS CMGs. Evidence appraisals in CMGs generally focused on novel drugs rather than basic supportive care; where evidence for the latter was provided it was generally of a low quality. Most CMGs had major methodological flaws (only two MERS-CoV and four COVID-19 CMGs we...