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Developing trustworthy recommendations as part of an urgent response (1-2 weeks)
A GRADE concept paper
Akl, E. A., Morgan, R. L., Rooney, A. A., Beverly, B., Katikireddi, 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, J., ... Schünemann, H. (2021). Developing trustworthy recommendations as part of an urgent response (1-2 weeks): A GRADE concept paper. Journal of Clinical Epidemiology, 129, 1-11. https://doi.org/10.1016/j.jclinepi.2020.09.037
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.
