title: Transparent development of the WHO rapid advice guidelines.
abstract: 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.
authors.affiliation: Italian National Cancer Institute Regina Elena, Department of Epidemiology, Rome, Italy. Schuneh@mcmaster.ca
authors.forename: Holger J
authors.initials: HJ
authors.lastname: Schünemann
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Hill
authors.forename: Meetali
authors.initials: M
authors.lastname: Kakad
authors.forename: Gunn E
authors.initials: GE
authors.lastname: Vist
authors.forename: Richard
authors.initials: R
authors.lastname: Bellamy
authors.forename: Lauren
authors.initials: L
authors.lastname: Stockman
authors.forename: Torbjørn Fosen
authors.initials: TF
authors.lastname: Wisløff
authors.forename: Chris
authors.initials: C
authors.lastname: Del Mar
authors.forename: Frederick
authors.initials: F
authors.lastname: Hayden
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
authors.forename: Howard
authors.initials: H
authors.lastname: Zucker
authors.forename: John
authors.initials: J
authors.lastname: Beigel
authors.forename: Tawee
authors.initials: T
authors.lastname: Chotpitayasunondh
authors.forename: Tran Tinh
authors.initials: TT
authors.lastname: Hien
authors.forename: Bülent
authors.initials: B
authors.lastname: Ozbay
authors.forename: Norio
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authors.lastname: Sugaya
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Oxman
mesh_terms: 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*