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Developing Treatment Guidelines During a Pandemic Health Crisis: Lessons Learned From COVID-19.
Abstract
The development of the National Institutes of Health (NIH) COVID-19 Treatment Guidelines
began in March 2020 in response to a request from the White House Coronavirus Task
Force. Within 4 days of the request, the NIH COVID-19 Treatment Guidelines Panel was
established and the first meeting took place (virtually-as did subsequent meetings).
The Panel comprises 57 individuals representing 6 governmental agencies, 11 professional
societies, and 33 medical centers, plus 2 community members, who have worked together
to create and frequently update the guidelines on the basis of evidence from the most
recent clinical studies available. The initial version of the guidelines was completed
within 2 weeks and posted online on 21 April 2020. Initially, sparse evidence was
available to guide COVID-19 treatment recommendations. However, treatment data rapidly
accrued based on results from clinical studies that used various study designs and
evaluated different therapeutic agents and approaches. Data have continued to evolve
at a rapid pace, leading to 24 revisions and updates of the guidelines in the first
year. This process has provided important lessons for responding to an unprecedented
public health emergency: Providers and stakeholders are eager to access credible,
current treatment guidelines; governmental agencies, professional societies, and health
care leaders can work together effectively and expeditiously; panelists from various
disciplines, including biostatistics, are important for quickly developing well-informed
recommendations; well-powered randomized clinical trials continue to provide the most
compelling evidence to guide treatment recommendations; treatment recommendations
need to be developed in a confidential setting free from external pressures; development
of a user-friendly, web-based format for communicating with health care providers
requires substantial administrative support; and frequent updates are necessary as
clinical evidence rapidly emerges.
Type
Journal articleSubject
NIH COVID-19 Treatment Guidelines PanelHumans
Data Interpretation, Statistical
Drug Approval
Interprofessional Relations
Evidence-Based Medicine
Pregnancy
National Institutes of Health (U.S.)
Child
Advisory Committees
United States
Female
Practice Guidelines as Topic
Pandemics
Stakeholder Participation
COVID-19
SARS-CoV-2
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https://hdl.handle.net/10161/26426Published Version (Please cite this version)
10.7326/m21-1647Publication Info
Kuriakose, Safia; Singh, Kanal; Pau, Alice K; Daar, Eric; Gandhi, Rajesh; Tebas, Pablo;
... Worthington, Christopher (2021). Developing Treatment Guidelines During a Pandemic Health Crisis: Lessons Learned From
COVID-19. Annals of internal medicine, 174(8). pp. 1151-1158. 10.7326/m21-1647. Retrieved from https://hdl.handle.net/10161/26426.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Brenna L Hughes
Professor of Obstetrics and Gynecology
Susanna Naggie
Professor of Medicine
Dr. Susanna Naggie completed her undergraduate degrees in chemical engineering and
biochemistry at the University of Maryland, College Park, and her medical education
at Johns Hopkins School of Medicine. She conducted her internal medicine and infectious
diseases fellowship training at Duke University Medical Center, where she also served
as Chief Resident. She joined the faculty in the Duke School of Medicine in 2009.
She is a Professor of Medicine and currently holds appointments at the Duk
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