为了评估可用性,质量,以及2019年冠状病毒病(covid-19)大流行早期产生的临床指南的包容性。
快速审查。
OvidMedline,OvidEmbase,Ovid全球健康,Scopus,WebofScience核心合集,和世界卫生组织全球指数药物,从成立之初到2020年3月14日进行搜索。搜索策略应用了CADTH数据库指南搜索过滤器,对搜索结果没有限制。通过使用ISARIC网络搜索灰色文献,确定了进一步的研究。
covid-19,中东呼吸综合征(MERS)的临床指南,包括国际和国家科学组织以及政府和非政府组织与全球卫生有关的严重急性呼吸系统综合症(SARS),不排除语言。地区/医院指南被排除在外。仅包括任何指南的最早版本。
使用评估研究和评估指南(AGREE)II工具评估质量。还将早期covid-19指南的质量和内容与最近的MERS和SARS临床指南进行了比较。
确定了2836项研究,其中2794人在筛查后被排除.42条准则被认为有资格纳入,18是covid-19特有的。总的来说,临床指南缺乏细节,涵盖的主题范围狭窄.关于以下方面的建议各不相同,例如,使用抗病毒药物。整体质量较差,特别是在利益相关者参与的领域,适用性,编辑独立。证据和建议之间的联系有限。为孕妇等弱势群体提供的资金最少,孩子们,和老年人。
covid-19大流行早期可用的指南存在方法上的弱点,并忽视了老年人等弱势群体。需要在公共卫生紧急情况下制定临床指南的框架,以确保采取严格的方法并纳入弱势群体。
PROSPEROCRD42020167361。
To appraise the availability, quality, and inclusivity of clinical
guidelines produced in the early stage of the coronavirus disease 2019 (covid-19) pandemic.
Rapid review.
Ovid Medline, Ovid Embase, Ovid Global Health, Scopus, Web of Science Core Collection, and WHO Global Index Medicus, searched from inception to 14 Mar 2020. Search strategies applied the CADTH database guidelines search filter, with no limits applied to search results. Further studies were identified through searches of grey literature using the ISARIC network.
Clinical guidelines for the management of covid-19, Middle East respiratory syndrome (MERS), and severe acute respiratory syndrome (SARS) produced by international and national scientific organisations and government and non-governmental organisations relating to global health were included, with no exclusions for language. Regional/hospital
guidelines were excluded. Only the earliest version of any
guideline was included.
Quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. The quality and contents of early covid-19
guidelines were also compared with recent clinical
guidelines for MERS and SARS.
2836 studies were identified, of which 2794 were excluded after screening. Forty two
guidelines were considered eligible for inclusion, with 18 being specific to covid-19. Overall, the clinical
guidelines lacked detail and covered a narrow range of topics. Recommendations varied in relation to, for example, the use of antiviral drugs. The overall quality was poor, particularly in the domains of stakeholder involvement, applicability, and editorial independence. Links between evidence and recommendations were limited. Minimal provision was made for vulnerable groups such as pregnant women, children, and older people.
Guidelines available early in the covid-19 pandemic had methodological weaknesses and neglected vulnerable groups such as older people. A framework for development of clinical guidelines during public health emergencies is needed to ensure rigorous methods and the inclusion of vulnerable populations.
PROSPERO CRD42020167361.