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. 2007 May;4(5):e119.
doi: 10.1371/journal.pmed.0040119.

Transparent development of the WHO rapid advice guidelines

Holger J Schünemann  1 , Suzanne R Hill, Meetali Kakad, Gunn E Vist, Richard Bellamy, Lauren Stockman, Torbjørn Fosen Wisløff, Chris Del Mar, Frederick Hayden, Timothy M Uyeki, Jeremy Farrar, Yazdan Yazdanpanah, Howard Zucker, John Beigel, Tawee Chotpitayasunondh, Tran Tinh Hien, Bülent Ozbay, Norio Sugaya, Andrew D Oxman
Affiliations

Transparent development of the WHO rapid advice guidelines

Holger J Schünemann et al. PLoS Med. 2007 May.

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.

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Conflict of interest statement

Competing Interests: Panel members made the following declarations regarding possible conflicts of interest according to WHO rules for the period 2002–2006. HJS received no personal funding, but has received research grants and honoraria deposited into research accounts or given to a research group that he belongs to from Pfizer, Amgen, Roche, and AstraZeneca for development or consulting regarding quality-of-life instruments for chronic respiratory diseases. CDM has received funding for trials in unrelated therapeutic areas, but not in the last four years. FH has received research grants for trials of antivirals and vaccines from Roche, Abbott, BioCrest, and Merck. YY has received no personal funding, but is an investigator on trials with Tibotec Pharmaceutical and has received travel grants from GlaxoSmithKline, Roche, Boehringer Ingelheim, Bristol-Myers Squibb, Pfizer, Abbott, and Gilead to attend scientific meetings. JB has received no personal funding, but is an investigator (through the National Institutes of Health) on trials with Roche and BioCrest. NS has received travel grants from Roche to attend meetings on avian influenza. The remaining members of the panel had no relevant conflicts of interest to declare.

Figures

Figure 1
Figure 1. Example of a GRADE Evidence Profile
Footnotes 1–15 in [21] provided detailed information about the rationale underlying the decisions.
Figure 2
Figure 2. Summary of Findings for the Following Scenario: Should Oseltamivir Be Used for Treatment of Patients Hospitalized with Avian Influenza (H5N1)?
Figure 3
Figure 3. Decisions about the Strength of a Recommendation
See this image and copyright information in PMC

Comment in

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