Principles for developing and adapting clinical practice guidelines and guidance for pandemics, wars, shortages, and oth
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Principles for developing and adapting clinical practice guidelines and guidance for pandemics, wars, shortages, and other crises and emergencies: the PAGE criteria Murad Alam1 · Vishnu Harikumar1 · Sarah A. Ibrahim1 · Bianca Y. Kang1 · Ian A. Maher2 · Todd V. Cartee3 · Joseph F. Sobanko4 · Nour Kibbi5 · Joshua L. Owen1,31 · Kelly A. Reynolds1 · Diana Bolotin6 · Abigail H. Waldman7 · Kira Minkis8 · Brian Petersen9 · M. Laurin Council10 · Kishwer S. Nehal11 · Y. Gloria Xu12 · S. Brian Jiang13 · Ally‑Khan Somani14 · Christopher K. Bichakjian15 · Conway C. Huang16 · Daniel B. Eisen17 · David M. Ozog18 · Erica H. Lee11 · Faramarz H. Samie19 · Isaac M. Neuhaus20 · Jeremy S. Bordeaux21,22 · Jordan V. Wang23 · Justin J. Leitenberger24 · Margaret W. Mann21,22 · Naomi Lawrence25 · Nathalie C. Zeitouni26 · Nicholas Golda27 · Ramona Behshad28 · Sherrif F. Ibrahim29 · Siegrid S. Yu20 · Thuzar M. Shin4 · William G. Stebbins30 · Brandon Worley1 Received: 14 October 2020 / Revised: 30 October 2020 / Accepted: 3 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
In recent years, the development of clinical practice guidelines has become a more formalized and ubiquitous process. The AGREE II [1, 2] and RIGHT [3] paradigms provide instruction for reporting guidelines development; GRADE [4] and other systems have been refined for assessing the level of evidence and qualifying the strength of recommendations. Nationally recognized authorities such as the NCCN [5], professional medical societies with guidelines committees [6, 7], interdisciplinary working groups, the National Guidelines Clearinghouse [8] and successor organizations are all playing key roles in developing and disseminating guidelines. The reasons for guideline development are many. Given the increased interest in quality of care, guidelines can be helpful for educating providers about best practices and decreasing variation in care delivery. Guidelines can also help introduce new therapies or diagnostic interventions, and clarify their role in patient management. Guidelines for rare conditions or diseases can spark interest in them and illuminate areas where knowledge is lacking, thereby stimulating further research. When high-level evidence is lacking but providers need direction, guidelines based largely on expert opinion can fill the gap. Payers and regulators can also look to guidelines to better understand the standard of care, even though guidelines documents typically include a disclaimer specifically disavowing any intent to create or reinforce such a standard. Even patients can benefit from guidelines, which * Murad Alam m‑[email protected]
may help them learn about their condition and its common management options. Clinical practice guidelines are general documents designed to apply to most affected patients in commonly encountered clinical situations. While certain special circumstances may be envisioned, guidelines are not usually intended for situations in which normal care delivery is interrupted. Thus
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