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利用可靠的实时证据综合分析和指南制定为德国的大流行管理提供信息:从 COVID-19 证据生态系统中吸取的经验教训。

Informing pandemic management in Germany with trustworthy living evidence syntheses and guideline development: lessons learned from the COVID-19 evidence ecosystem.

机构信息

Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 86, D-79110 Freiburg, Germany.

Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, D-50937 Cologne, Germany.

出版信息

J Clin Epidemiol. 2024 Sep;173:111456. doi: 10.1016/j.jclinepi.2024.111456. Epub 2024 Jul 14.

Abstract

OBJECTIVES

We present the 'COVID-19 evidence ecosystem' (CEOsys) as a German network to inform pandemic management and to support clinical and public health decision-making. We discuss challenges faced when organizing the ecosystem and derive lessons learned for similar networks acting during pandemics or health-related crises.

STUDY DESIGN AND SETTING

Bringing together 18 university hospitals and additional institutions, CEOsys key activities included research prioritization, conducting living systematic reviews (LSRs), supporting evidence-based (living) guidelines, knowledge translation (KT), detecting research gaps, and deriving recommendations, backed by technical infrastructure and capacity building.

RESULTS

CEOsys rapidly produced 31 high-quality evidence syntheses and supported three living guidelines on COVID-19-related topics, while also developing methodological procedures. Challenges included CEOsys' late initiation in relation to the pandemic outbreak, the delayed prioritization of research questions, the continuously evolving COVID-19-related evidence, and establishing a technical infrastructure. Methodological-clinical tandems, the cooperation with national guideline groups and international collaborations were key for efficiency.

CONCLUSION

CEOsys provided a proof-of-concept for a functioning evidence ecosystem at the national level. Lessons learned include that similar networks should, among others, involve methodological and clinical key stakeholders early on, aim for (inter)national collaborations, and systematically evaluate their value. We particularly call for a sustainable network.

摘要

目的

我们展示了“COVID-19 证据生态系统”(CEOsys),这是一个德国网络,旨在为大流行管理提供信息,并支持临床和公共卫生决策。我们讨论了在组织生态系统时面临的挑战,并为在大流行或与健康相关的危机期间运作的类似网络得出了经验教训。

研究设计和背景

将 18 所大学医院和其他机构联合起来,CEOsys 的主要活动包括研究优先级排序、进行实时系统评价(LSR)、支持基于证据的(实时)指南、知识转化(KT)、发现研究差距和提出建议,这些活动得到了技术基础设施和能力建设的支持。

结果

CEOsys 迅速生成了 31 项高质量的证据综合,并支持了三项关于 COVID-19 相关主题的实时指南,同时还制定了方法学程序。面临的挑战包括 CEOsys 相对于大流行爆发的启动较晚、研究问题的优先级排序延迟、不断演变的 COVID-19 相关证据以及建立技术基础设施。方法学-临床串联、与国家指南小组的合作和国际合作是提高效率的关键。

结论

CEOsys 为国家层面的功能齐全的证据生态系统提供了一个概念验证。得出的经验教训包括,类似的网络应尽早纳入方法学和临床方面的主要利益相关者,旨在(进行)国际合作,并系统地评估其价值。我们特别呼吁建立一个可持续的网络。

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