Guidelines developed under pressure. The case of the COVID-19 low-quality “rapid” guidelines and potential solutions

Florez, I. D., Amer, Y. S., McCaul, M., Lavis, J. N., & Brouwers, M. (2021). Guidelines developed under pressure. The case of the COVID-19 low-quality “rapid” guidelines and potential solutions. Journal of clinical epidemiology142, 194–199. Advance online publication. https://doi.org/10.1016/j.jclinepi.2021.11.012 FREE

Introduction

The COVID-19 global pandemic led to a substantial investment into the funding, execution, and publication/dissemination of research at unprecedented speeds and volumes. This, in turn, has created an urgent need to manage and curate this evidence to inform public health, clinical and health-system decision-making. Eager to provide some type of guidance in a scenario of uncertainty, many organizations started developing guidelines to provide recommendations to manage COVID-19 patients. Clinical practice guidelines (CPGs) have been published since the early stages of the pandemic, often in very short time frames, with a scarcity of evidence, with evidence that in other contexts would be considered of questionable quality and using methods that do not meet traditional development and reporting norms.

Some of these early CPGs were labeled as “rapid advice”, “rapid guidelines”, or “interim recommendations” [1][2][3] implying they were developed under a pressuring situation, their methods were expedited, or developers applied methodological shortcuts. However, most of the CPGs developed during 2020, presumably under time constraints, were not labeled as rapid guidelines. Rather, they were labeled or presented as regular guidelines, using the usual terms: “guidelines”, “statements”, or “recommendations.”

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