Rapid and llving guidance for COVID-19 [Editorial]

    Ann. intern. med; 174 (8), 2021
    Publication year: 2021

    The COVID-19 pandemic is stress testing our evidence systems. The tremendous output of COVID-19 research and the need for clinicians and other decision makers to have trusted, up-to-date sources of evidence and guidance during a time of great uncertainty have highlighted the limitations of conventional approaches. The pandemic has been a reminder that too often our decisions are informed either by guidance developed using rigorous scientific methods or by sources that are up to date with the latest research—but not both. Seldom do we find sources that are an accurate reflection of research knowledge by being both methodologically rigorous and current. Although the COVID-19 pandemic has highlighted many of the flaws in our evidence systems, it has also shown the value of novel approaches, including in examples where the rigor or currency tradeoff has been broken. Qaseem and colleagues at the American College of Physicians (ACP) responded to the urgent need for guidance during the pandemic by producing living, rapid practice points. They report their methods in this issue of Annals (2). The ACP team followed conventional processes for the development of recommendations, with 2 important modifications. First, their initial development was accelerated using methods for rapid reviews and recommendations. Second, these practice points are being maintained in a living, frequently updated state to incorporate new research as it becomes available.