20 Turning Research Results into Clinical Practice Guidelines in Public Health Emergencies

Clinical practice guidelines (CPGs) assist clinicians with medical decision making for diagnosis, prevention, and management of medical conditions. Traditional CPGs for established diseases generally follow a lengthy process during which robust, peer-reviewed published data are used to formulate recommendations in a CPG panel. In public health challenges such as HIV and hepatitis C, a different paradigm is necessary. HIV and hepatitis C are areas in which changing data emerged rapidly, and as such CPGs needed to be done carefully but quickly. The magnitude of the coronavirus disease 2019 (COVID-19) public health emergency, the rapid emergence of important new epidemiologic and clinical data, the availability of an immense amount of information from non-peer-reviewed sources such as the Internet, social media platforms, and pre-prints, along with public expectations for current and objective advice regarding prevention and treatment of COVID-19, warranted the creation of an emergency CPG panel that was quite different from any previous CPG, including those for HIV and hepatitis C. For healthcare practitioners, public health officials, and other stakeholders, there are many lessons to be learned here about the creation of CPGs that can rapidly provide much-needed guidance in a credible, current, understandable format, which can have a major impact on healthcare, patient outcomes, and the trajectory of an epidemic or pandemic.