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Review
. 2023 Jun 12;38(23):e195.
doi: 10.3346/jkms.2023.38.e195.

Two Years of Experience and Methodology of Korean COVID-19 Living Clinical Practice Guideline Development

Miyoung Choi #  1 , Hyeon-Jeong Lee #  1 , Su-Yeon Yu  1   2 , Jimin Kim  1 , Jungeun Park  1 , Seungeun Ryoo  1 , Inho Kim  1 , Dong Ah Park  1 , Young Kyung Yoon  3 , Joon-Sung Joh  4 , Sunghoon Park  5 , Ki Wook Yun  6 , Chi-Hoon Choi  7 , Jae-Seok Kim  8 , Sue Shin  9 , Hyun Kim  10 , Kyungmin Huh  11 , In-Seok Jeong  12 , Soo-Han Choi  13 , Sung Ho Hwang  14 , Hyukmin Lee  15 , Dong Keon Lee  16 , Hwan Seok Yong  17 , Ho Kee Yum  18
Affiliations
Review

Two Years of Experience and Methodology of Korean COVID-19 Living Clinical Practice Guideline Development

Miyoung Choi et al. J Korean Med Sci. .

Abstract

Background: In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration.

Methods: The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations.

Results: An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3-4 months.

Conclusion: We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media. Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.

Keywords: COVID-19; GRADE Approach; Living Evidence; Practice Guidelines as Topic; Systematic Review.

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Conflict of interest statement

The COI management committee consisted of 7 members, including the chairs of the GDG, members recommended by the chairs, and outside experts who confirmed the COI declaration form. In the early stage of the practice guidelines development, the COI declaration form was distributed to all committee members (including all members of the GDG) and a survey of the COI was conducted. Throughout the guideline development period, any changes could be voluntarily submitted to the COI management committee. For any reported COI case, at least 2 committee members independently reviewed each case and made determinations. The final decision was made during a general meeting with the COI committee. After the members were reviewed for possible COIs, the COI committee’s decision was held in person or via e-mail. If the COI committee decided that the reported COI impacted at moderate to high levels, members’ activities could be limited to reviewing evidence and not voting for decision-making. Over the 2-year period, 1 member’s reported academic COI was determined as ‘low’ and the other member who reported financial COI was determined as ‘moderate’ by the COI committee (Table 1).

Figures

Fig. 1
Fig. 1. Guideline development group.
KAMS = Korean Academy of Medical Sciences, NECA = National Evidence-based Healthcare Collaborating Agency, COI = Conflict of Interest.
Fig. 2
Fig. 2. Flow diagram of Korean coronavirus disease 2019 living guideline process.
See this image and copyright information in PMC

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