“Closing the chasm” – guidelines bridge the gap from evidence to implementation

摘要

Since the beginning of the Coronavirus Disease 2019 (COVID-19) pandemic, over 9000 articles related to COVID-19 have been released in print by the end of December 2020.1 A majority of these articles were commentaries, several hundred were observational studies, 55 were systematic reviews, and 4 were randomized controlled trials. The American College of Rheumatology has published updated clinical guidance for the management of multisystem inflammatory syndrome in children associated with SARS-CoV-2, the most recent version in April 2021.2,3 Additionally, practice guidelines for pediatric specialties in the setting of COVID-19 have also been published, including pulmonology, anesthesiology, infectious disease, orthopedics, and anticoagulation.4-8 The rapid development and dissemination of these guidelines during the pandemic has been unprecedented. Many of these guidelines are based primarily on consensus statements rather than randomized control trials, which have been the gold standard of evidence-based medicine. In this commentary, we discuss the role of practice guidelines from credible sources that are based on incrementally emerging evidence to guide bedside practice, until they can be updated with more robust data from meta-analyses of randomized trials.