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The methodological quality is insufficient in clinical practice guidelines in the context of COVID-19: systematic review.

Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090, Vienna, Austria. Electronic address: tanja.stamm@meduniwien.ac.at. Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria. Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Richmond, British Columbia, Canada. Medicine Program, Faculty of Health Sciences, University of Magdalena, Santa Marta, Colombia. Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK. School of Applied Psychology, Griffith University, Mt. Gravatt, Australia. Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Physical Medicine and Rehabilitation, University of Michigan and VA Ann Arbor Health Care System, Ann Arbor, MI, USA. Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Austrian Association of Dietitians, Vienna, Austria. The Cyprus League Against Rheumatism and Platform Organization for People for Rheumatic Diseases in Southern Europe, Nicosia, Cyprus. Office of Patient Experience, Children's Hospital Los Angeles, Los Angeles, CA, USA. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. Department of Radiation Oncology, UCLA Health, Los Angeles, CA, USA. Department of Podiatry, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa. Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090, Vienna, Austria. Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Savvy Cooperative, Queens, NY, USA. Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems an der Donau, Austria; RTI International, Research Triangle Park, NC, USA.

Journal of clinical epidemiology. 2021;:125-135
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Abstract

OBJECTIVES The number of published clinical practice guidelines related to COVID-19 has rapidly increased. This study explored if basic methodological standards of guideline development have been met in the published clinical practice guidelines related to COVID-19. STUDY DESIGN AND SETTING Rapid systematic review from February 1 until April 27, 2020 using MEDLINE [PubMed], CINAHL [Ebsco], Trip and manual search, including all types of healthcare workers providing any kind of healthcare to any patient population in any setting. RESULTS There were 1342 titles screened and 188 guidelines included. The highest average AGREE II domain score was 89% for scope and purpose, the lowest for rigor of development (25%). Only eight guidelines (4%) were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality). The majority (156; 83%) was solely built on an informal expert consensus. A process for regular updates was described in 27 guidelines (14%). Patients were included in the development of only one guideline. CONCLUSION Despite clear scope, most publications fell short of basic methodological standards of guideline development. Clinicians should use guidelines that include up-to-date information, were informed by stakeholder involvement, and employed rigorous methodologies.