Weekly updates of national living evidence-based guidelines: Methods for the Australian Living Guidelines for Care of People with COVID-19

Abstract

BACKGROUND: The Australian National COVID-19 Clinical Evidence Taskforce is a consortium of 31 Australian health professional organisations developing living, evidence-based guidelines for care of people with COVID-19 which are updated weekly. This paper describes the methods used to develop and maintain the guidelines. METHODS: The guidelines use GRADE methods and are designed to meet Australian NHMRC standards. Each week, new evidence is reviewed, current recommendations are revised and new recommendations made. These are published in MAGIC and disseminated through traditional and social media. Relevant new questions to be addressed are continually sought from stakeholders and practitioners. For prioritised questions, the evidence is actively monitored and updated. Evidence surveillance combines horizon scans and targeted searches. An Evidence Team appraises and synthesises evidence and prepares evidence-to-decision frameworks to inform development of recommendations. A Guidelines Leadership Group oversees the development of recommendations by multidisciplinary Guidelines Panels and is advised by a Consumer Panel. RESULTS: and Discussion: The Taskforce formed in March 2020, and the first recommendations were published two weeks later. The guidelines have been revised and republished on a weekly basis for 24 weeks, and as of October 2020 contain over 90 treatment recommendations, suggesting that living methods are feasible in this context. CONCLUSIONS: The Australian Guidelines for Care of People with COVID-19 provide an example of the feasibility of living guidelines, and an opportunity to test and improve living evidence methods.