Quality Assessment of 45 Guidelines on Management of Critical Care Patients with COVID-19: A Systematic Review and AGREE II Instrument Assessment
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abstract
Background: In response to the COVID-19 pandemic, a host of rapid guidelines (RGs) have been published to inform clinicians and decision-makers on best management for people with COVID-19. We assessed the quality of RGs for management of critically ill patients with COVID-19.
Methods: We performed a rapid systematic review of RGs for the critical care patients with COVID-19. Medline (OVID), CINAHL (EBSCO), EMBASE, CNKI, CBM, WanFang, and relevant databases and websites were systematically searched through 31 st July 2020. The AGREE II instrument was used to assess the quality of included RGs and summarize relevant therapeutic interventions.
Results: A total of 45 RGs for critically ill patients with COVID-19 were included. Ten were multinational and the remaining from individual countries. The clinical topics included in each RG varied: 41 were for general critical care unit management, two covered patients with tracheostomy, six covered children, four covered women, five covered cardiovascular diseases, 12 covered emergencies, 19 covered patients with pneumonia, and one was for patients receiving renal replacement therapy. Average scores for the six domains of the AGREE II instrument were 70%, 40%, 26%, 74%, 28%, 41% for the scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, editorial independence, respectively. Recommendations for therapeutic interventions were summarized.
Interpretation: Most of the RGs for critical care in response to COVID-19 included in the review showed a low overall quality (less than 40%). Future RGs for COVID-19 need to rely, for their development, on standard evidence-based methods and tools.
Funding Statement: This work was supported by the Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.
