International alliance and AGREE-ment of 71 clinical practice guidelines on the management of critical care patients with COVID-19: a living systematic review

doi:10.1016/j.jclinepi.2021.11.010

. 2022 Feb:142:333-370.

doi: 10.1016/j.jclinepi.2021.11.010. Epub 2021 Nov 14.

International alliance and AGREE-ment of 71 clinical practice guidelines on the management of critical care patients with COVID-19: a living systematic review

Yasser S Amer¹, Maher A Titi², Mohammad W Godah³, Hayfaa A Wahabi⁴, Layal Hneiny⁵, Manal Mohamed Abouelkheir⁶, Muddathir H Hamad⁷, Ghada Metwally ElGohary⁸, Mohamed Ben Hamouda⁹, Hella Ouertatani¹⁰, Pamela Velasquez-Salazar¹¹, Jorge Acosta-Reyes¹², Samia M Alhabib¹³, Samia Ahmed Esmaeil¹⁴, Zbys Fedorowicz¹⁵, Ailing Zhang¹⁶, Zhe Chen¹⁶, Sarah Jayne Liptrott¹⁷, Niccolò Frungillo¹⁸, Amr A Jamal⁴, Sami A Almustanyir¹⁹, Newman Ugochukwu Dieyi²⁰, John Powell²¹, Katrina J Hon²², Rasmieh Alzeidan²³, Majduldeen Azzo²⁴, Sara Zambrano-Rico²⁵, Paulina Ramirez-Jaramillo²⁵, Ivan D Florez²⁶

Affiliations

¹ Pediatrics Department and Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia; Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia; Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University Medical Council, Alexandria University, Alexandria, Egypt.
² Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia; Patient Safety Unit, Quality Management Department King Saud University Medical City, Riyadh, Saudi Arabia.
³ Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁴ Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia; Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁵ Saab Medical Library, University Libraries, American University of Beirut, Beirut, Lebanon.
⁶ Department of Clinical Pharmacy, College of Pharmacy, Misr International University, Cairo, Egypt.
⁷ Division of Neurology, Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
⁸ Internal Medicine and Clinical Hematology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; University Oncology Center, University Medical City, King Saud University, Riyadh, Saudi Arabia.
⁹ Clinical Practice Guidelines Unit, INEAS l instance Nationale de l'évaluation et de l'accréditation en santé 7 Rue Ahmed Rami le belvedere 1001 Tunis-TUNISIA.
¹⁰ Clinical Pathways Unit, National Authority for Assessment and Accreditation in Healthcare (INEAS), Tunis, Tunisia.
¹¹ Unidad de Evidencia y Deliberación para la toma de Decisiones (UNED), Faculty of Medicine, University of Antioquia, Medellín, Colombia.
¹² Department of Public Health, Universidad del Norte, Barranquilla, Colombia.
¹³ National Center for Evidence-Based Health Practice, Saudi Health Council, Riyadh, Saudi Arabia; King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
¹⁴ Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.
¹⁵ Veritas Health Sciences Consultancy Ltd., Huntingdon, United Kingdom.
¹⁶ First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
¹⁷ Ente Ospedaliero Cantonale, via Gallino 12, 6500 Bellinzona, Switzerland.. Electronic address: sarahjayne.liptrott@eoc.ch.
¹⁸ Oncology Unit, ASST Fatebenefratelli-Sacco, PO Fateberefratelli, Piazza Principessa Clotilde 3, 20121, Milan, Italy.
¹⁹ Ministry of Health, Riyadh, Saudi Arabia.
²⁰ Division of Community Health and Humanities, Memorial University, St. John's Newfoundland and Labrador, Canada.
²¹ National Institute for Health and Care Excellence, London, UK; Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK.
²² Division of Community Health and Humanities, Memorial University, St. John's Newfoundland and Labrador, Canada; Neuroscience, Mind, Brain, and Behavior, Harvard University, MA, USA.
²³ Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
²⁴ Pediatrics Emergency Department, The International Medical Center, Hail Street, 21451, Jeddah, Saudi Arabia.
²⁵ CES University, Medellín Colombia.
²⁶ Department of Pediatrics, University of Antioquia, Medellin, Colombia; School of Rehabilitation Science, McMaster University, Hamilton, Canada. Electronic address: ivan.florez@udea.edu.co.

PMID: 34785346
PMCID: PMC8590623
DOI: 10.1016/j.jclinepi.2021.11.010

International alliance and AGREE-ment of 71 clinical practice guidelines on the management of critical care patients with COVID-19: a living systematic review

Yasser S Amer et al. J Clin Epidemiol. 2022 Feb.

. 2022 Feb:142:333-370.

doi: 10.1016/j.jclinepi.2021.11.010. Epub 2021 Nov 14.

Authors

Affiliations

¹ Pediatrics Department and Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia; Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia; Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University Medical Council, Alexandria University, Alexandria, Egypt.
² Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia; Patient Safety Unit, Quality Management Department King Saud University Medical City, Riyadh, Saudi Arabia.
³ Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
⁴ Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia; Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁵ Saab Medical Library, University Libraries, American University of Beirut, Beirut, Lebanon.
⁶ Department of Clinical Pharmacy, College of Pharmacy, Misr International University, Cairo, Egypt.
⁷ Division of Neurology, Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
⁸ Internal Medicine and Clinical Hematology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; University Oncology Center, University Medical City, King Saud University, Riyadh, Saudi Arabia.
⁹ Clinical Practice Guidelines Unit, INEAS l instance Nationale de l'évaluation et de l'accréditation en santé 7 Rue Ahmed Rami le belvedere 1001 Tunis-TUNISIA.
¹⁰ Clinical Pathways Unit, National Authority for Assessment and Accreditation in Healthcare (INEAS), Tunis, Tunisia.
¹¹ Unidad de Evidencia y Deliberación para la toma de Decisiones (UNED), Faculty of Medicine, University of Antioquia, Medellín, Colombia.
¹² Department of Public Health, Universidad del Norte, Barranquilla, Colombia.
¹³ National Center for Evidence-Based Health Practice, Saudi Health Council, Riyadh, Saudi Arabia; King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
¹⁴ Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.
¹⁵ Veritas Health Sciences Consultancy Ltd., Huntingdon, United Kingdom.
¹⁶ First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
¹⁷ Ente Ospedaliero Cantonale, via Gallino 12, 6500 Bellinzona, Switzerland.. Electronic address: sarahjayne.liptrott@eoc.ch.
¹⁸ Oncology Unit, ASST Fatebenefratelli-Sacco, PO Fateberefratelli, Piazza Principessa Clotilde 3, 20121, Milan, Italy.
¹⁹ Ministry of Health, Riyadh, Saudi Arabia.
²⁰ Division of Community Health and Humanities, Memorial University, St. John's Newfoundland and Labrador, Canada.
²¹ National Institute for Health and Care Excellence, London, UK; Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK.
²² Division of Community Health and Humanities, Memorial University, St. John's Newfoundland and Labrador, Canada; Neuroscience, Mind, Brain, and Behavior, Harvard University, MA, USA.
²³ Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
²⁴ Pediatrics Emergency Department, The International Medical Center, Hail Street, 21451, Jeddah, Saudi Arabia.
²⁵ CES University, Medellín Colombia.
²⁶ Department of Pediatrics, University of Antioquia, Medellin, Colombia; School of Rehabilitation Science, McMaster University, Hamilton, Canada. Electronic address: ivan.florez@udea.edu.co.

PMID: 34785346
PMCID: PMC8590623
DOI: 10.1016/j.jclinepi.2021.11.010

Abstract

Objective: We aimed to systematically identify and critically assess the clinical practice guidelines (CPGs) for the management of critically ill patients with COVID-19 with the AGREE II instrument.

Study design and setting: We searched Medline, CINAHL, EMBASE, CNKI, CBM, WanFang, and grey literature from November 2019 - November 2020. We did not apply language restrictions. One reviewer independently screened the retrieved titles and abstracts, and a second reviewer confirmed the decisions. Full texts were assessed independently and in duplicate. Disagreements were resolved by consensus. We included any guideline that provided recommendations on the management of critically ill patients with COVID-19. Data extraction was performed independently and in duplicate by two reviewers. We descriptively summarized CPGs characteristics. We assessed the quality with the AGREE II instrument and we summarized relevant therapeutic interventions.

Results: We retrieved 3,907 records and 71 CPGs were included. Means (Standard Deviations) of the scores for the 6 domains of the AGREE II instrument were 65%(SD19.56%), 39%(SD19.64%), 27%(SD19.48%), 70%(SD15.74%), 26%(SD18.49%), 42%(SD34.91) for the scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, editorial independence domains, respectively. Most of the CPGs showed a low overall quality (less than 40%).

Conclusion: Future CPGs for COVID-19 need to rely, for their development, on standard evidence-based methods and tools.

Keywords: AGREE II tool; COVID-19; guidelines; intensive care; quality; rapid guidelines.

PubMed Disclaimer

Figures

**Figure 1**
PRISMA Flow Diagram of study selection.

See this image and copyright information in PMC

Cited by

Methodological quality and reporting quality of COVID-19 living systematic review: a cross-sectional study.
Luo J, Chen Z, Liu D, Li H, He S, Zeng L, Yang M, Liu Z, Xiao X, Zhang L. Luo J, et al. BMC Med Res Methodol. 2023 Jul 31;23(1):175. doi: 10.1186/s12874-023-01980-y. BMC Med Res Methodol. 2023. PMID: 37525117 Free PMC article.
A living critical interpretive synthesis to yield a framework on the production and dissemination of living evidence syntheses for decision-making.
Mansilla C, Wang Q, Piggott T, Bragge P, Waddell K, Guyatt G, Sweetman A, Lavis JN. Mansilla C, et al. Implement Sci. 2024 Sep 27;19(1):67. doi: 10.1186/s13012-024-01396-2. Implement Sci. 2024. PMID: 39334425 Free PMC article. Review.
Searching for evidence in public health emergencies: a white paper of best practices.
Brody S, Loree S, Sampson M, Mensinkai S, Coffman J, Mueller MH, Askin N, Hamill C, Wilson E, McAteer MB, Staines H; Best Practices for Searching During Public Health Emergencies Working Group. Brody S, et al. J Med Libr Assoc. 2023 Apr 21;111(1-2):566-578. doi: 10.5195/jmla.2023.1530. J Med Libr Assoc. 2023. PMID: 37312802 Free PMC article.
Characteristics of Living Systematic Review for COVID-19.
Chen Z, Luo J, Li S, Xu P, Zeng L, Yu Q, Zhang L. Chen Z, et al. Clin Epidemiol. 2022 Aug 4;14:925-935. doi: 10.2147/CLEP.S367339. eCollection 2022. Clin Epidemiol. 2022. PMID: 35958161 Free PMC article.
Involvement of methodological experts and the quality of clinical practice guidelines: a critical appraisal of clinical practice guidelines and a questionnaire survey of the development groups in Japan.
Hatakeyama Y, Seto K, Onishi R, Hirata K, Matsumoto K, Wu Y, Hasegawa T. Hatakeyama Y, et al. BMJ Open. 2023 May 15;13(5):e063639. doi: 10.1136/bmjopen-2022-063639. BMJ Open. 2023. PMID: 37188477 Free PMC article.

See all "Cited by" articles

References

1. Dagens A, Sigfrid L, Cai E, Lipworth S, Cheung V, Harris E, et al. Scope, quality, and inclusivity of clinical guidelines produced early in the covid-19 pandemic: rapid review. BMJ. 2020:369. - PMC - PubMed
1. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. Who.int. 2020 [cited 6 April 2020]. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-re...
1. Covid19.who.int. 2020. WHO Coronavirus Disease (COVID-19) Dashboard. [online] Available at: <https://covid19.who.int/> [Accessed 15 Feb 2021].
1. Bong CL, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 Pandemic: effects on low- and middle-income countries. Anesth Analg. 2020;131(1):86–92. doi: 10.1213/ANE.0000000000004846. - DOI - PMC - PubMed
1. Iyengar K, Mabrouk A, Jain VK, Venkatesan A, Vaishya R. Learning opportunities from COVID-19 and future effects on health care system. Diabetes Metab Syndr. 2020;14(5):943–946. doi: 10.1016/j.dsx.2020.06.036. Epub 2020 Jun 20. PMID: 32599533; PMCID: PMC7305503. - DOI - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

[1] Dagens A, Sigfrid L, Cai E, Lipworth S, Cheung V, Harris E, et al. Scope, quality, and inclusivity of clinical guidelines produced early in the covid-19 pandemic: rapid review. BMJ. 2020:369. - PMC - PubMed

[2] Dagens A, Sigfrid L, Cai E, Lipworth S, Cheung V, Harris E, et al. Scope, quality, and inclusivity of clinical guidelines produced early in the covid-19 pandemic: rapid review. BMJ. 2020:369. - PMC - PubMed

[3] WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. Who.int. 2020 [cited 6 April 2020]. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-re...

[4] WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. Who.int. 2020 [cited 6 April 2020]. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-re...

[5] Covid19.who.int. 2020. WHO Coronavirus Disease (COVID-19) Dashboard. [online] Available at: <https://covid19.who.int/> [Accessed 15 Feb 2021].

[6] Covid19.who.int. 2020. WHO Coronavirus Disease (COVID-19) Dashboard. [online] Available at: <https://covid19.who.int/> [Accessed 15 Feb 2021].

[7] Bong CL, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 Pandemic: effects on low- and middle-income countries. Anesth Analg. 2020;131(1):86–92. doi: 10.1213/ANE.0000000000004846. - DOI - PMC - PubMed

[8] Bong CL, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 Pandemic: effects on low- and middle-income countries. Anesth Analg. 2020;131(1):86–92. doi: 10.1213/ANE.0000000000004846. - DOI - PMC - PubMed

[9] Iyengar K, Mabrouk A, Jain VK, Venkatesan A, Vaishya R. Learning opportunities from COVID-19 and future effects on health care system. Diabetes Metab Syndr. 2020;14(5):943–946. doi: 10.1016/j.dsx.2020.06.036. Epub 2020 Jun 20. PMID: 32599533; PMCID: PMC7305503. - DOI - PMC - PubMed

[10] Iyengar K, Mabrouk A, Jain VK, Venkatesan A, Vaishya R. Learning opportunities from COVID-19 and future effects on health care system. Diabetes Metab Syndr. 2020;14(5):943–946. doi: 10.1016/j.dsx.2020.06.036. Epub 2020 Jun 20. PMID: 32599533; PMCID: PMC7305503. - DOI - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

International alliance and AGREE-ment of 71 clinical practice guidelines on the management of critical care patients with COVID-19: a living systematic review

Affiliations

International alliance and AGREE-ment of 71 clinical practice guidelines on the management of critical care patients with COVID-19: a living systematic review

Authors

Affiliations

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Medical