Evidence map›Paper›PMID 34889948›Full record

SynthesisJAMA network open2021

Adherence of Clinical Practice Guidelines for Pharmacologic Treatments of Hospitalized Patients With COVID-19 to Trustworthy Standards: A Systematic Review.

Karen E A Burns, Matthew Laird, James Stevenson, Kimia Honarmand, David Granton, Michelle E Kho, Deborah Cook, Jan O Friedrich, Maureen O Meade, Mark Duffett and 8 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JAMA network open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Review
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Karen E A BurnsInterdepartmental Division of Critical Care Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Matthew LairdSchool of Medicine, Royal College of Surgeons, Dublin, Ireland.
James StevensonSchool of Medicine, Royal College of Surgeons, Dublin, Ireland.
Kimia HonarmandDepartment of Critical Care Medicine, London Health Sciences Centre, London, Ontario, Canada.
David GrantonInterdepartmental Division of Critical Care Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Michelle E KhoDepartments of Medicine, Critical Care Medicine, Pediatrics and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Deborah CookDepartments of Medicine, Critical Care Medicine, Pediatrics and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Jan O FriedrichInterdepartmental Division of Critical Care Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Maureen O MeadeDepartments of Medicine, Critical Care Medicine, Pediatrics and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Mark DuffettDepartments of Medicine, Critical Care Medicine, Pediatrics and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Dipayan ChaudhuriDepartments of Medicine, Critical Care Medicine, Pediatrics and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Kuan LiuDalla Lana School of Public Health and the Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Frederick D'AragonCanadian Donation and Transplant Research Program, Ottawa, Ontario, Canada.
Arnav AgarwalInterdepartmental Division of Critical Care Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Neill K J AdhikariDalla Lana School of Public Health and the Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Hayle Noh
Bram RochwergDepartments of Medicine, Critical Care Medicine, Pediatrics and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Academy of Critical Care: Development, Evaluation, and Methodology (ACCADEMY)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The COVID-19 pandemic created the need for rapid and urgent guidance for clinicians to manage COVID-19 among patients and prevent transmission. Objective: To appraise the quality of clinical practice guidelines (CPGs) using the National Academy of Medicine (NAM) criteria. Evidence Review: A search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials to December 14, 2020, and a search of related articles to February 28, 2021, that included CPGs developed by societies or by government or nongovernment organizations that reported pharmacologic treatments of hospitalized patients with COVID-19. Teams of 2 reviewers independently abstracted data and assessed CPG quality using the 15-item National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) instrument. Findings: Thirty-two CPGs were included in the review. Of these, 25 (78.1%) were developed by professional societies and emanated from a single World Health Organization (WHO) region. Overall, the CPGs were of low quality. Only 7 CPGs (21.9%) reported funding sources, and 12 (37.5%) reported conflicts of interest. Only 5 CPGs (15.6%) included a methodologist, described a search strategy or study selection process, or synthesized the evidence. Although 14 CPGs (43.8%) made recommendations or suggestions for or against treatments, they infrequently rated confidence in the quality of the evidence (6 of 32 [18.8%]), described potential benefits and harms (6 of 32 [18.8%]), or graded the strength of the recommendations (5 of 32 [15.6%]). External review, patient or public perspectives, or a process for updating were rare. High-quality CPGs included a methodologist and multidisciplinary collaborations involving investigators from 2 or more WHO regions. Conclusions and Relevance: In this review, few COVID-19 CPGs met NAM standards for trustworthy guidelines. Approaches that prioritize engagement of a methodologist and multidisciplinary collaborators from at least 2 WHO regions may lead to the production of fewer, high-quality CPGs that are poised for updates as new evidence emerges. Trial Registration: PROSPERO Identifier: CRD42021245239.

Indexed as

COVID-19 Drug TreatmentHospitalizationPandemicsAcademies and InstitutesDelivery of Health CareHumansPractice Guidelines as TopicSARS-CoV-2Societies, MedicalTrust

Identifiers

PMID34889948
PMCPMC8665373

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.