Answering the call: responsive evidence generation for guideline developers

Background

Cochrane promotes evidence-based decision making, and as such aims to support guideline development internationally. Cochrane Infectious Diseases Group (CIDG) aims to impact policy in tropical diseases in a diverse range of resource-limited settings. Our funding is contingent on demonstrating our impact.

Objectives

To review CIDG’s approach to responsive evidence generation for global and national guideline developers to identify lessons learnt.

Methods

We performed a qualitative review of our process, including methods of engagement, our response, and the outcomes in relation to guideline requests in infectious diseases in the last two years. We also used a consultative process as a team to reflect on the lessons we have learnt.

Results

The CIDG responded to three guideline panel requests from World Health Organization (WHO) Geneva on treating Crimea-Congo Haemorrhagic Fever; preventing and treating cryptococcal disease in people living with HIV; and preventing, diagnosing and treating plague; one from Pan American Health Organization (PAHO) in the treatment of histoplasmosis in people living with HIV; and one from the Ministry of Health in India, in opportunistic infections.

Our methods for response varied according to time frame, adopting rapid review methodology where necessary without compromising on rigor, using laboratory data, and requiring us to often work outside of Cochrane editorial procedures, and working with a sense of urgency to tight deadlines.

We will present further details of the analysis, including impact and our reflections on the lessons learnt, and the lessons for Cochrane in terms of staying relevant and responsive, at the colloquium.

Conclusions

Responding to guideline evidence summaries needs Cochrane-trained people to be more flexible, operate with a sense of urgency, but maintaining independence and rigor.

Patient or healthcare consumer involvement: the guideline panel questions are often shaped by consumer inputs, and all consumers want the best guidance as quickly as possible in life-threatening, unusual infectious diseases.

The full recording is available here and below.