National COVID-19 Taskforce: keeping on top of the evidence

Sourcing up-to-date reliable information on COVID-19 management and treatment can be difficult. There are so many different sources of information, from peer-reviewed journals, mainstream media, social media, peers, media statements and ‘preprints’ — or non-peer reviewed journal articles.

What makes this even more complicated is the potential bias associated with some of these sources of information. The key question then springs to mind: how can I find reliable information? Information where all the work has been done — assessing bias, quality of evidence, synthesising this with existing literature and consider the practical and clinical implications of recommendations. This is where a COVID-19 Clinical Evidence Taskforce (https://covid19evidence.net.au/) comes in very handy.

The Taskforce, led by Executive Director A/Professor Julian Elliott, is a diverse coalition of peak health bodies that focus on clinical care of Australians with COVID-19. At the time of writing, the number of peak bodies involved stands at 30 and includes the Australasian College for Infection Prevention and Control (ACIPC), Australian and New Zealand College of Anaesthetists (ANZCA), Australian and New Zealand Intensive Care Society (ANZICS), Royal Australian College of General Practitioners (RACGP) and many more (https://covid19evidence.net.au/about-the-taskforce/). Despite being led in Australia, the evidence is widely accessed internationally.

“Through the National COVID-19 Clinical Evidence Taskforce we’ve established a truly world-class collaboration of experts who work around the clock to identify, evaluate and implement global COVID-19 research findings. This means that frontline clinicians have a trusted single source of evidence-based guidance in a time of great uncertainty,” says A/Professor Julian Elliott.

A first of its kind, the National COVID-19 Clinical Evidence Taskforce provides a clear and consistent voice of cross-disciplinary consensus on the clinical care of patients with COVID-19. The team work around the clock to analyse global research findings, evaluate the evidence, collate and prioritise clinicians’ questions and update COVID-19 clinical guidelines and clinical flowcharts. Traditionally, clinical guidelines are updated every few years, but the Taskforce has developed ‘living’ guidelines, updated each and every week.

The evidence surveillance system used, tracks and identifies relevant studies as results are available, allowing teams to identify and summarise global COVID-19 research findings. Findings are synthesised and reviewed by feed into 7 expert guideline panels where recommendations are formed. Recommendations are then reviewed by the Guidelines Leadership Group each week, which comprises the 30 leading health organisations covering primary, acute and critical care settings around Australia. Where full consensus has been met from all organisations, recommendations are then published.

Recommendations are presented as a flowchart (https://covid19evidence.net.au/#clinical-flowcharts) or in a living guideline (https://covid19evidence.net.au/#living-guidelines). Living guidelines contain detailed information regarding the reviews undertaken including certainty of evidence, evidence summaries, forest plots, rationale and more. All information and data is transparently reported. The Taskforce include pre-prints in the evidence reviews, providing full data is available. Certainty of evidence and the data is reviewed again, once the final publication is published.

Such an approach does require considerable resources, as well as voluntary work. The approach used is a world first and in times of a pandemic, having clear transparent information is critical.

Professor Brett Mitchell is from the School of Nursing and Midwifery at the University of Newcastle and is a Member of the COVID-19 National Guidelines Leadership Group.