Researchers at McMaster University, along with an international team of collaborators, have launched a freely accessible living map of COVID-19 guidelines. In developing the electronic platform, their goal is to help decision-makers quickly access and use the best available scientific advice related to the pandemic from around the world.
Those decision-makers could be healthcare professionals, researchers, policymakers or members of the general public, urgently looking for evidence-based guidance on public health measures, clinical management of COVID-19 and related health conditions, or economic and social responses to the pandemic, such as workplace support and online learning.
“Even when the outbreak was not yet defined as a pandemic, there was a clear gap in the guidance,” said Dr. Tamara Lotfi (MD, MPH), a research associate and project coordinator with McMaster University’s WHO Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, in an interview with Research Money. “That was the first sign that there needed to be one place where anyone who could be affected by the pandemic could go to look at advice of the best-available quality; that is produced by the most-acknowledged and recognized organizations globally; and that could be used in decision-making.”
Lotfi co-leads the new project with McMaster colleagues Dr. Holger Schünemann (MD, PhD) and Dr. Adrienne Stevens (PhD). The map is a collaboration between McMaster’s WHO Collaborating Centre, Cochrane Canada, Evidence Prime, the Norwegian Institute of Public Health, the Guidelines International Network, and researchers in nine countries.
“There has been a profusion of local (often poor-quality) guidelines. This resource may help folks build from the recommendations of international high-quality guidelines and adapt them for their local context,” wrote Dr. Jeremy Grimshaw (MBCHB, PHD), a senior scientist at the Ottawa Health Research Institute and Canada Research Chair in Health Knowledge Transfer and Uptake, in an email to Research Money.
Grimshaw co-leads the COVID-19 Evidence Network (COVID-END), a COVID-19 knowledge synthesis network aiming to support Canadian decision-makers, which received a $1-million grant from the Canadian Institutes for Health Research (CIHR) earlier this month.
“We see the recommendation work as highly complementary to our other ongoing work. Different stakeholders (citizens, clinicians, managers and policymakers) have diverse informational needs and preferences about content and format. The recommendation work adds to the currently available resources,” he wrote.
The living map project is also funded by CIHR. The team received a $1.45-million grant last May through the agency's COVID-19 Rapid Research Funding Opportunity. A phased rollout of the tool began in mid December, and new recommendations and features are being added regularly.
The COVID-19 Recommendations Map currently contains more than 500 recommendations in French and English; current priority areas include guidance on vaccinations, schools, and the anti-parasite drug ivermectin, which has been touted as a treatment for COVID-19 in some countries despite limited evidence to support its use.
The map takes advantage of recent developments in data science that allow researchers to capture and organize large amounts of heterogeneous data, and joins a new generation of software tools designed to support evidence-based decision making in healthcare and other domains.
Technology aside, the map’s value lies in the breadth and quality of the recommendations it surfaces, their underlying evidence and the speed at which they are incorporated. Recommendations are sourced from PubMed, directly from global organizations that routinely publish clinical practice and public health guidelines, such as the World Health Organization, the United Kingdom’s National Institute for Health and Care Excellence, the Public Health Agency of Canada, and elsewhere. The team evaluates the quality of each recommendation using a standardized assessment tool, and makes the assessment scores available to users within the tool.
The platform provides a single point of access—“one-stop shopping,” according to Schünemann—where users can search for recommendations, find quality assessments, and link to the primary evidence on which the recommendations are based. It is integrated with two living maps of COVID-19 evidence, created by the Norwegian Institute for Public Health and LOVE, as well as the WHO's Essential Medicine's List.
Beginning this week, users will also be able to contextualize their search queries to make timely decisions at the local, national and international levels.
‘We believe that these links, in particular, support our efforts to facilitate contextualization through adoption, adaption or de novo recommendation development using these multiple integrated tools. We call this process ‘adolopment,’” Schünemann said in a recent CanCOVID webinar about the new tool.
The team is continuing to build partnerships, rapidly update and expand the recommendations, and accelerate their processes. For example, they are working with GRADEPro, a software tool for guideline developers and authors of systematic reviews, created by Evidence Prime, a McMaster spin-off company. In the near future, guideline developers focused on COVID-19 will be able to use a customized version of GRADEPro, which will allow their work to be pushed directly to the map, said Lotfi, who urged guideline developers to get in touch and share their work with the team.