Participation of stakeholders in the Development of a Clinical Guideline focused on decreasing the COVID-19 transmission risk in dentistry
2Dental School, Universidad del Sinú, Cartagena, Colombia
3Faculty of Dentistry, Universidad de Cartagena, Cartagena, Colombia
Background: Clinical practice guidelines (CPGs) are documents systematically developed to help clinicians and patients in the decision-making process. They are a great tool to translate evidence into practice. However, their applicability could decrease if they do not involve stakeholders during their development.
Objectives: To develop a CPG focused on decreasing COVID-19 transmission risk in dentistry with the participation of the stakeholders
Methods: We developed a CPG focused on decreasing COVID-19 transmission risk in dentistry following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. A systematic search of the literature was conducted to identify the evidence of COVID-19 transmission in dental settings. The quality of evidence was determined using different tools. Stakeholders participated in all processes from the determination of clinical questions to the generation of recommendations. In addition, a questionary was used to assess the experience of stakeholders during their participation in the CPG development.
Results: Among the recommendations to reduce the COVID-19 transmission risk during dental care are the use of personal protective equipment and N95 masks, high-speed instruments equipped with an anti-retraction system, and surface disinfection with ethanol. Overall, most recommendations included in the CPG were classified as “conditional” by the panel and were based on a “low” or “very low” level of evidence. Likewise, some clinical questions were addressed under a narrative format which provides a useful context for clinicians and patients. Around 97% of stakeholders considered that their participation was useful, so it could improve the quality and applicability of the CPG.
Conclusions: Most stakeholders self-reported that their participation was considered valued during the development process of a CPG including recommendations to reduce COVID-19 transmission risk in dental settings. However, for many participants, it was the first time that they were involved in the development of a CPG; thus, greater efforts are needed to encourage the participation of stakeholders in all processes to synthesize the evidence in this field.
Patient, public and/or healthcare consumer involvement: The CPG committee was composed of dentists, methodologists, experts in the field, patients, and government authorities.