To provide specific, patient-focused recommendations for the clinical care of people with suspected or confirmed COVID-19, where care for this patient group differs from usual care provided to patients with similar clinical conditions (pneumonia, severe acute respiratory distress, etc.).
We will revise scope as necessary, in discussion with members of the Taskforce and the guideline panels, and with endorsement by the Executive of the Taskforce.
We work with a range of stakeholders to ensure that questions in the living guideline are important and relevant for Australian clinicians and consumers.
First, we gather potential new clinical topics and questions using: (a) input and advice from organisational partners of the Taskforce and other stakeholders; (b) suggestions received from clinicians and consumers through our website or via the guideline feedback portal on MAGICapp; and (c) issues raised by our Evidence Review Team.
Then, we screen these topics and questions to determine if they are within the guideline scope (as listed above). Topics and questions that are deemed to be within scope are then prioritised for inclusion by the Guideline Leadership Group and relevant Guideline Panel. Clinical questions are prioritised according to the following criteria:
Questions that are considered to be a priority are assigned to the Evidence Review Team to identify and synthesise available evidence. This evidence is then reviewed by the appropriate Guideline Panel.
The preliminary recommendations contained within this guideline are based on an analysis of existing national and international guidelines focused on the treatment of adults with COVID-19. These guidelines were sourced by members of the Taskforce and collaborators.
The second stage of the process will involve updating these recommendations using data identified from peer-reviewed primary studies. The search methods are currently being developed to inform this stage, and further information will be provided when this process is finalised. Cochrane is establishing an annotated register of COVID-19 study reports that will include all human studies of COVID-19, focusing initially on interventional, diagnostic and prognostic studies. The Cochrane COVID-19 register is the principal source of relevant research.
Where research is available to address our questions, we conduct living systematic reviews as the basis of evidence summaries, and draft evidence-based recommendations following GRADE methods, to be considered and revised by our guideline panels. We may, as the panels agree is appropriate, draw on studies providing indirect evidence from patients with SARS/MERS/pandemic influenza.
We have convened multidisciplinary guideline panels to consider the research evidence, review consensus recommendations developed by other guideline groups, and contribute clinical expertise. These panels include clinicians with a range of expertise from a variety of clinical settings across Australia. All panel members complete a declaration of potential conflicts of interest, and absent themselves from discussions related to these potential conflicts.
We currently have six guideline panels, addressing patients across all disease severities, from mild to critical illness, as well as special populations including pregnant and breastfeeding women, children and adolescents and palliative and aged care.
We will recruit new panel members, and convene further panels, to address particular areas of clinical expertise or need as they arise. Future panel expansion may include policy-maker involvement and consumer representation, and may address population groups with special care requirements, such as children, pregnant women, people who are immunosuppressed and those with comorbid conditions.
We base recommendations on the best available research evidence (where evidence is available to guide decision-making), the consensus recommendations of guideline groups convened in other jurisdictions, and the expert experience of the guideline panels.
Where possible, these processes follow GRADE methods, adapted as necessary to be suitable for the expedited nature of the process. Where adaptations to the GRADE methods are made, these are documented and the methods used clearly described.
Guideline panels consider, refine and agree new and revised existing recommendations at weekly, fortnightly or monthly meetings or as new research emerges.
New and revised recommendations made by the guideline panels are endorsed by the National Steering Committee of the Taskforce. Endorsed recommendations are published online in MAGICapp and disseminated through traditional and social media channels.