An evaluation of WHO emergency guidelines for Zika virus disease. Issue 3 (18th June 2019)

• Record Type: Journal Article
• Authors: Norris, Susan L; Louis, Henry; Sawin, Veronica I; Porgo, Teegwendé V; Lau, Yuk Hei Agnes; Wang, Qi; Ferri, Mauricio
• Is Part Of: Journal of evidence-based medicine. Volume 12:Issue 3(2019)
• Page Start: 218
• Page End: 224
• Publication Date: 2019-06-18
• Subjects: AGREE II -- evaluation studies -- evidence‐based practice -- global health -- guidelines -- methods -- quality control -- World Health Organization -- Zika virus disease; Evidence-based medicine -- Periodicals; Systematic reviews (Medical research) -- Periodicals; 616.005
• DOI: 10.1111/jebm.12347
• Languages: English
• ISSNs: 1756-5383

Abstract

Abstract: Background: In the face of an unclear causal association between Zika virus in utero exposure and congenital abnormalities and urgent demand for guidance, the World Health Organization (WHO) had to produce timely and trustworthy guidelines during the 2016 Public Health Emergency of International Concern (PHEIC). Methods: This is a cross‐sectional evaluation of WHO emergency guidelines produced during the Zika virus disease PHEIC from 1 February to 18 November 2016. We assessed adherence to WHO publication requirements and the reporting of guideline development processes associated with trustworthiness. In the absence of quality appraisal tools for guidelines developed under compressed timeframes, we applied the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Results: We included 21 guidelines (13 de novo and 8 updates). Six guidelines used a formal evidence review process. Most guidelines involved external experts in the development process and collected declarations of interest. Peer review was reported in six documents. Most emergency guidelines included updating plans. The highest scoring AGREE II domain was clarity of presentation (median score 78%); the lowest scoring domain was applicability (median score 18%). Conclusion: WHO developed moderate‐ to high‐quality emergency guidelines in the challenging context of a PHEIC. We found improvement opportunities for WHO guideline development teams in the use of evidence to formulate recommendations, the collection of declarations of interest, reporting of conflicts of interest, and the use of existing WHO organizational quality assurance processes.