WHO Guidelines Review Committee, World Health Organization, Geneva, Switzerland.
National School of Public Health, Madrid, Spain.
PLoS One. 2018 May 30;13(5):e0198125. doi: 10.1371/journal.pone.0198125. eCollection 2018.
The production of high-quality guidelines in response to public health emergencies poses challenges for the World Health Organization (WHO). The urgent need for guidance and the paucity of structured scientific data on emerging diseases hinder the formulation of evidence-informed recommendations using standard methods and procedures.
In the context of the response to recent public health emergencies, this project aimed to describe the information products produced by WHO and assess the quality and trustworthiness of a subset of these products classified as guidelines.
We selected four recent infectious disease emergencies: outbreaks of avian influenza A-H1N1 virus (2009) and H7N9 virus (2013), Middle East respiratory syndrome coronavirus (MERS-CoV) (2013), and Ebola virus disease (EVD) (2014 to 2016). We analyzed the development and publication processes and evaluated the quality of emergency guidelines using AGREE-II.
We included 175 information products of which 87 were guidelines. These products demonstrated variable adherence to WHO publication requirements including the listing of external contributors, management of declarations of interest, and entry into WHO's public database of publications. For guidelines, the methods for development were incompletely reported; WHO's quality assurance process was rarely used; systematic or other evidence reviews were infrequently referenced; external peer review was not performed; and they scored poorly with AGREE II, particularly for rigour of development and editorial independence.
Our study suggests that WHO guidelines produced in the context of a public health emergency can be improved upon, helping to assure the trustworthiness and utility of WHO information products in future emergencies.
世界卫生组织（WHO）在应对突发公共卫生事件时制定高质量指南面临挑战。由于急需指导意见，并且新兴疾病的结构化科学数据不足，因此无法使用标准方法和程序制定基于证据的推荐意见。
在应对近期突发公共卫生事件的背景下，本项目旨在描述世卫组织制作的信息产品，并评估其中一部分被归类为指南的产品的质量和可信度。
我们选择了四种最近的传染病突发事件：甲型 H1N1 禽流感病毒（2009 年）和 H7N9 病毒（2013 年）、中东呼吸综合征冠状病毒（MERS-CoV）（2013 年）以及埃博拉病毒病（2014 年至 2016 年）。我们分析了制定和出版流程，并使用 AGREE-II 评估了紧急情况指南的质量。
我们共纳入 175 份信息产品，其中 87 份为指南。这些产品对世卫组织出版要求的遵守程度各不相同，包括外部贡献者的列示、利益声明的管理以及纳入世卫组织出版物公共数据库。对于指南，制定方法的报告不完整；很少使用世卫组织的质量保证程序；很少参考系统或其他证据审查；没有进行外部同行评审；并且在 AGREE II 中得分较低，特别是在制定的严谨性和编辑独立性方面。
我们的研究表明，在世卫组织应对突发公共卫生事件的背景下制定的指南可以得到改进，有助于确保世卫组织在未来的突发事件中信息产品的可信度和实用性。
