Transparent development of the WHO rapid advice guidelines.
Emerging health problems require rapid advice. We describe the development and pilot testing of a systematic, transparent approach used by the World Health Organization (WHO) to develop rapid advice guidelines in response to requests from member states confronted with uncertainty about the pharmacological management of avian influenza A (H5N1) virus infection. We first searched for systematic reviews of randomized trials of treatment and prevention of seasonal influenza and for non-trial evidence on H5N1 infection, including case reports and animal and in vitro studies. A panel of clinical experts, clinicians with experience in treating patients with H5N1, influenza researchers, and methodologists was convened for a two-day meeting. Panel members reviewed the evidence prior to the meeting and agreed on the process. It took one month to put together a team to prepare the evidence profiles (i.e., summaries of the evidence on important clinical and policy questions), and it took the team only five weeks to prepare and revise the evidence profiles and to prepare draft guidelines prior to the panel meeting. A draft manuscript for publication was prepared within 10 days following the panel meeting. Strengths of the process include its transparency and the short amount of time used to prepare these WHO guidelines. The process could be improved by shortening the time required to commission evidence profiles. Further development is needed to facilitate stakeholder involvement, and evaluate and ensure the guideline's usefulness.
Schünemann
Holger J
HJ
Italian National Cancer Institute Regina Elena, Department of Epidemiology, Rome, Italy. Schuneh@mcmaster.ca
Hill
Suzanne R
SR
Kakad
Meetali
M
Vist
Gunn E
GE
Bellamy
Richard
R
Stockman
Lauren
L
Wisløff
Torbjørn Fosen
TF
Del Mar
Chris
C
Hayden
Frederick
F
Uyeki
Timothy M
TM
Farrar
Jeremy
J
Yazdanpanah
Yazdan
Y
Zucker
Howard
H
Beigel
John
J
Chotpitayasunondh
Tawee
T
Hien
Tran Tinh
TT
Ozbay
Bülent
B
Sugaya
Norio
N
Oxman
Andrew D
AD
D026683:Advisory Committees / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype; D007251:Influenza, Human / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D016730:Program Development; D014944:World Health Organization / Q000458:organization & administration*