The speed at which guidance needs to be produced during the COVID-19 outbreak poses a huge challenge to guidance producing bodies around the globe. Outbreak guidance is known for the need to be ‘fast but right’, but now that COVID-19 is affecting health systems, including other parts of clinical care, primary care, long-term care, care for ageing adults, mental health care, and many more, guidance for a wide range of sectors is being developed at a fraction of the time that is usually required.
This poses an acute challenge: how to appraise and include wide ranging types of knowledge to come to robust guidance in the absence of frequentist (RCT-based) evidence? How to do so without resorting to expert opinion without empirical checks-and-balances? And how to balance harms, benefits and efficiencies, especially when already marginalized communities risk paying the highest price?
The working group on Appraising and Including Different Knowledge (AID Knowledge) of the Guidelines International Network (G-I-N) is launching two initiatives to inventory methods deployed and provide peer support in producing rapid guidance. It will run 1) inventory current methods and approaches for rapid knowledge appraisal and inclusion, as predominantly used by G-I-N members and will 2) run several webinars/workshops for guidance developers where leaders from different care sectors give short presentations, followed by peer support for challenges raised in break-out rooms. These initiatives serve the dual aim of 1) providing current support to those developing guidance under unprecedented conditions and 2) inventorying methods that, though used now, may impact the future of guideline development. Already guideline developing bodies are reflecting on how these rapid approaches will impact their practices in future. Where ‘rapid guidance’ was still a niche in guideline development, where most guidelines take years to develop, this is likely to change due to COVID-19. If it does, knowledge appraisal methods that are rapid but also robust need to be documented. Now is the time to do so.
If you are interested in joining the webinars/workshops, please contact Teun Zuiderent-Jerak.
Written by dr. Teun Zuiderent-Jerak