Weekly Updating of Guideline Recommendations is Feasible: The Australian National COVID-19 Clinical Evidence Taskforce

Objective: To investigate how quickly evidence was incorporated into the Australian living guidelines for COVID-19 during the first 12 months of the pandemic. Study Design and Setting: For each study concerning drug therapies included in the guideline from April 3, 2020 to April 1, 2021 we extracted the publication date of the study and the guideline version the study was included in. We analysed two subgroups of studies: those published in high impact factor journals and those with 100 or more participants. Results: In the first year we published 37 major versions of the guidelines, incorporating 129 studies that investigated 48 drug therapies informing 115 recommendations. The median time from first publication of a study to incorporation in the guideline was 27 days (IQR 16 to 44), ranging from 9 to 234 days. For the 53 studies in the highest impact factor journals, the median was 20 days (IQR 15 to 30) and for the 71 studies with 100 or more participants the median was 22 days (IQR 15 to 36). Conclusion: Developing and sustaining living guidelines where evidence is rapidly incorporated is a resource- and time-intensive undertaking, however this study demonstrates that it is feasible, even over a long period.