快速指南的制定：2. 与世界卫生组织指南制定者进行的定性研究。
Development of rapid guidelines: 2. A qualitative study with WHO guideline developers.
机构信息
Department of Health Research Methods, Evidence and Impact and Mac GRADE Center, McMaster University Health Sciences Centre, Room 2C16, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada.
Department of Pediatrics, University of Antioquia, Cra. 51D #62-29, Medellin, 050001, Colombia.
出版信息
Health Res Policy Syst. 2018 Jul 13;16(1):62. doi: 10.1186/s12961-018-0329-6.
BACKGROUND
Situations such as public health emergencies and outbreaks necessitate the development and publication of high-quality recommendations within a condensed timeframe. For example, WHO has produced examples of and guidance for the development of rapid guidelines (RGs). However, more information is needed to understand the experiences and perceptions of guideline developers. This is the second of a series of three articles addressing methodological issues around RGs. This study describes the perceptions and experiences of guideline developers at WHO about RGs.
METHODS
We conducted interviews consisting of open- and closed-ended questions with guideline developers at WHO. Our analysis described the definition and rationale of RGs, the differences from regular guidelines with regard to timelines from topic definition until publication, barriers to identifying the evidence and the lack of a standard methodology to develop RGs.
RESULTS
We interviewed 10 participants, the majority of whom were comfortable with the current WHO definition of RGs. Most stated that the rationale for developing RGs should be in response to new evidence about efficacy, cost-effectiveness or safety. Respondents differed with regards to the amount of time RGs should take. While the majority of participants agreed that guidelines should be based on a systematic review, this step in the process was considered the most time and resource intensive. Challenges for developing RGs included limited personnel and financial resources as well as the lack of evidence. Facilitators, in turn, that may improve RG development include additional financial and personnel resources as well as the use of virtual meetings.
CONCLUSIONS
While our study suggests a strong need and rationale for the development of RGs, standardisation of timelines and guidance on panel composition, peer-review process, conduct of meetings and sources of permissible evidence require further research.
背景
公共卫生突发事件和疫情等情况需要在短时间内制定和发布高质量的建议。例如，世卫组织已经制定了快速指南（RGs）的范例和指南。然而，为了更好地了解指南制定者的经验和看法，还需要更多的信息。这是三篇关于 RG 方法问题的系列文章中的第二篇。本研究描述了世卫组织指南制定者对 RG 的看法和经验。
方法
我们与世卫组织的指南制定者进行了包含开放式和封闭式问题的访谈。我们的分析描述了 RG 的定义和基本原理、与常规指南在从主题定义到出版的时间线上的差异、确定证据的障碍以及缺乏制定 RG 的标准方法。
结果
我们采访了 10 名参与者，他们中的大多数人对世卫组织目前对 RG 的定义感到满意。大多数人表示，制定 RG 的理由应该是针对疗效、成本效益或安全性方面的新证据。受访者对 RG 所需的时间长短存在分歧。虽然大多数参与者都同意指南应该基于系统评价，但这一过程步骤被认为是最耗费时间和资源的。制定 RG 的挑战包括人员和财务资源有限以及证据不足。反过来，有助于 RG 开发的因素包括增加财务和人员资源以及使用虚拟会议。
结论
尽管我们的研究表明需要强烈制定 RG，并且制定 RG 的时间表和小组组成、同行评审流程、会议进行方式和允许证据来源的指导方针需要进一步研究。
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