Developing trustworthy recommendations as part of an urgent response (1-2 weeks): a GRADE concept paper

Authors	AKL E. A. MORGAN R. L. ROONEY A. A. BEVERLY B. KATIKREDDI S. V. AGARWAL A. ALPER B. S. ALVA-DIAZ C. AMATO L. ANSARI M. T. BROZEK J. CHU D. K. DAHM P. DARZI A. J. FALAVIGNA M. GARTLEHNER G. PARDO-HERNANDEZ H. KING V. KLUGAROVÁ Jitka LANGENDAM M. W. M. LOCKWOOD C. MAMMEN M. MATHIOUDAKIS A. G. MCCAUL M. MEERPOHL J. J. MINOZZI S. MUSTAFA R. A. NONINO F. PIGGOTT T. QASEEM A. RIVA J. RODIN R. SEKERCIOGLU N. SKOETZ N. TRAVERSY G. THAYER K. SCHUNEMANN H.
Year of publication	2021
Type	Article in Periodical
Magazine / Source	JOURNAL OF CLINICAL EPIDEMIOLOGY
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.sciencedirect.com/science/article/pii/S0895435620311239
Doi	http://dx.doi.org/10.1016/j.jclinepi.2020.09.037
Keywords	GRADE; Urgent recommendation; Pandemic; Trustworthy guideline
Description	Objectives: The aim of this study is to propose an approach for developing trustworthy recommendations as part of urgent responses (1-2 week) in the clinical, public health, and health systems fields. Study Design and Setting: We conducted a review of the literature, outlined a draft approach, refined the concept through iterative discussions, a workshop by the Grading of Recommendations Assessment, Development and Evaluation Rapid Guidelines project group, and obtained feedback from the larger Grading of Recommendations Assessment, Development and Evaluation working group. Results: A request for developing recommendations within 2 week is the usual trigger for an urgent response. Although the approach builds on the general principles of trustworthy guideline development, we highlight the following steps: (1) assess the level of urgency; (2) assess feasibility; (3) set up the organizational logistics; (4) specify the question(s); (5) collect the information needed; (6) assess the adequacy of identified information; (7) develop the recommendations using one of the 4 potential approaches: adopt existing recommendations, adapt existing recommendations, develop new recommendations using existing adequate systematic review, or develop new recommendations using expert panel input; and (8) consider an updating plan. Conclusion: An urgent response for developing recommendations requires building a cohesive, skilled, and highly motivated multidisciplinary team with the necessary clinical, scientific, and methodological expertise; adapting to shifting needs; complying with the principles of transparency; and properly managing conflicts of interest. (C) 2020 The Author(s). Published by Elsevier Inc.