The Australian National COVID-19 Clinical Evidence Taskforce – the impact of living guidelines in a critical area of clinical need
Background:
The emergence of COVID-19 presented a significant challenge for guideline developers. Owing to the unprecedented push by investigators to rapidly plan, conduct and publish results of clinical studies, traditional methods of guideline production were incapable of dealing with such high rates of evidence generation. On 23 March 2020, the Australian National COVID-19 Clinical Evidence Taskforce was established to rapidly identify and synthesise evidence specific to the treatment and care of people with COVID-19.
Objectives:
With representation from 35 peak national healthcare organisations, the impetus behind establishing the Taskforce was to avoid the development of multiple potentially conflicting guidelines by providing a single source of guidance for Australian clinicians treating individuals with COVID-19. The objective is to ensure clinicians have easy access to up-to-date evidence-based recommendations, promoting the best possible care for patients with COVID-19.
Methods:
By leveraging methods developed by the Australian Living Evidence Consortium, the Taskforce adopted a dynamic and reactive process of rapidly identifying and translating relevant evidence into actionable recommendations. The cycle involves daily searching and screening, data extraction, analysis, and quality assessment of relevant clinical trials, facilitated by key technology enablers (Covidence, RevMan, and MAGICapp). Recommendations are developed by an expert panel, discussed and ratified by the guideline leadership group and steering committee, and published online.
Results:
Since March 2020 and with the help of more than 200 contributors across eight topic-specific panels, the Taskforce have developed 180 recommendations and 23 flow charts across 128 guideline updates, which have attracted more than 600,000 unique website users globally. Within the first 12 months, as few as 13 days transpired from publication of a clinical study to its inclusion in an updated version of the guideline (median 20 days for high-priority topics).
Conclusions:
In the 3 years since its inception, the Taskforce has become an exemplar of how high-throughput living guidelines can become a critical part of the healthcare landscape, having established trust among Australian clinicians, garnered significant media attention, impacted Government policy, and catalysed collaborations with several national and international guideline development bodies, such as the UK National Institute for Health and Care Excellence (NICE).