J Korean Med Sci.  2023 Jun;38(23):e195. 10.3346/jkms.2023.38.e195.

Two Years of Experience and Methodology of Korean COVID-19 Living Clinical Practice Guideline Development

• Choi M
• Lee HJ
• Yu SY
• Kim J
• Park J
• Ryoo S
• Kim I
• Park DA
• Yoon YK
• Joh JS
• Park S
• Yun KW
• Choi CH
• Kim JS
• Shin S
• Kim H
• Huh K
• Jeong IS
• Choi SH
• Hwang SH
• Lee H
• Lee DK
• Yong HS
• Yum HK

• KMID: 2543883
• DOI: http://doi.org/10.3346/jkms.2023.38.e195

Abstract

Background
In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration.
Methods
The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations.
Results
An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3–4 months.
Conclusion
We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media. Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.

Keyword

COVID-19; Practice Guidelines as Topic; Living Evidence; Systematic Review; GRADE Approach

Figure

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  Fig. 1 Guideline development group.KAMS = Korean Academy of Medical Sciences, NECA = National Evidence-based Healthcare Collaborating Agency, COI = Conflict of Interest.

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  Fig. 2 Flow diagram of Korean coronavirus disease 2019 living guideline process.

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