Ugrás a metaadatok végére
Ugrás a metaadatok elejére

Overview

  • This page is a resource to help stakeholders working along the COVID-19 evidence-to guidance- to action - to data - to evidence cycle improve their work processes and results. The ultimately goal is to a soon as possible, improve COVID-19 care delivery and outcomes.
  • The tables below are designed to aggregate Collaborative participant recommendations for addressing steps in this COVID-19 knowledge ecosystem. The recommended tools and approaches are being gathered and will evolve over time as stakeholder input is received and community consensus around best practices - and the pandemic itself - evolve.

Recommendation Tables for Knowledge Ecosystem Steps

     Table List

  • Identify Studies
  • Synthesize Evidence
  • Produce Guidance
  • Make Guidance Computable
  • Implement Guidance
  • Analyze Care Results
  • Leverage Results Analysis (e.g., for Quality Improvement, Reporting, Evidence Generation)

Identify Studies


General RecommendationsAnticoagulationTesting/TriageOther (Long COVID, Vaccine, Steroids)
Input Sources
  • For steroids systematic meta-review, 8 sources have been identified these are (MEDLINE, CORD-19, L-OVE/Episteminokos, NIH iSearch COVID-19, EuropePMC, WHO COVID-19 Database, EMBASE + Prospero) 
Search Strategies



Output Repositories



Current Standards



Emerging Standards



Initiatives
  • Librarian Reserve Corps
    • COVID-Evidence Project - building a database to gather all the evidence around a drug (University of Basil - currently focused on hydroxychloroquine, but model could be adaptable to other targets)
    • Identification of sources to identify primary studies - validation study of specialized COVID-19 databases (systematic reviewers are going to different sources - this effort is to identify best practices)
    • Advocate for librarian representation in searches and reviews - leverage skillsets/best practices in this work
      [SLMC]: close gaps between needs that clinicians are seeing on the front line and topics covered in reviews guidelines
  • COKA Evidence/ Tools WG [Project Google Drive](work in process)



Tools/ Platforms



Other Best Practices



Synthesize Evidence


General RecommendationsAnticoagulationTesting/TriageOther (Long COVID, Vaccine, Steroids)
Input Sources
Output Repositories


Current Standards


Emerging Standards



Initiatives


Tools/ Platforms


Other Best Practices
  • COVID-NMA has initiated communication with all trialists to try to ensure consistent approaches e.g. selection of outcomes, reduction of risk of bias, and to invite them to contribute missing data. 
  • Framework slides: Applying Standards to the Evidence Domain (from the COKA Evidence Ecosystem Liaison WG)




Produce Guidance


General RecommendationsAnticoagulationTesting/TriageOther (Long COVID, Vaccine, Steroids)
Input Sources
  • See Output Repositories from Synthesize Evidence table

Output Repositories


Current Standards



Emerging Standards



Initiatives



Tools/ Platforms


Other Best Practices


Make Guidance Computable


General RecommendationsAnticoagulationTesting/TriageOther (Long COVID, Vaccine, Steroids)
Input Sources
  • See output repositories under Produce Guidance



Output Repositories


Current Standards


Emerging Standards


Initiatives



Tools/ Platforms


Other Best Practices

From C19HCC Digital Guideline WG:

  • Using CPG-on-FHIR standard for representing/ expressing the full intent of the Guidance in computer-interpretable artifacts (part of HL7 CPG-IG)
  • Using the Agile Approach to CPG Development (inclusive of Integrated Process) to concurrently Produce Guidance and Make Guidance Computable (part of HL7 CPG-IG)
  • Use Agile Knowledge Engineering methods, principles, and tools
    • Cross-functional Integrated team (Agile CPG Team)
    • Leverage composite nature of CPGs (e.g. can develop logic for inferences on patient information- CPG_CaseFeatures) to build incrementally and iteratively with rapid feedback
    • Pull knowledge engineers into Content design/reviews; pull domain SMEs into knowledge representation design/reviews
  • Leverage CPG-on-FHIR as a faithful expression of Guidance and its ability to create computationally derived CDS and Cognitive Support, patient-specific, practice-level digital Quality Measures/Metrics, eCaseReports, etc. to create computable artifacts used downstream in the Learning Health System and to provide closed-loop feedback/feedforward.
  • Leverage established tools and capabilities (e.g. BPM+ process and tooling, Clinical Ontology) to author computable Guidance and Open Source tooling to translated into HL7 CPG-on-FHIR to leverage derivative and native compute
  • tips:
    • Use established standards and work with standards community (to understand and evolve as needed)
    • Engage consumers/ users early and often
    • Engage downstream vendors (e.g Terminology vendor USED in the EHRs) early
    • Just because everyone everyone is using the same terminology systems doesn't mean they're agreeing how to use the actual terms- this needs to be considered and addressed to make ecosystem/supply chain work properly (feedforward from Evidence, but also feedback of data semantics back into evidence)
    • Learn from related communities of practice (e.g. Agile Software Engineering)



Implement Guidance (e.g., as CDS, eCQMs)


General RecommendationsAnticoagulationTesting/TriageOther (Long COVID, Vaccine, Steroids)
Input Sources
  • See output repositories for Make Guidance Computable



Current Standards



Emerging Standards



Initiatives
  • C19 Digital Guidelines WG developing and implementation guide for COVID-19 interventions



Tools/ Platforms



Other Best Practices


Analyze Care Results


General RecommendationsAnticoagulationTesting/TriageOther (Long COVID, Vaccine, Steroids)
Input Sources



Search Strategies



Output Repositories



Current Standards



Emerging Standards


Initiatives



Tools/ Platforms


Other Best Practices



Leverage Results Analysis (e.g., for Quality Improvement, Reporting, and Evidence Generation)


General RecommendationsAnticoagulationTesting/TriageOther (Long COVID, Vaccine, Steroids)
Input Sources



Output Repositories



Current Standards


Emerging Standards



Initiatives


Tools/ Platforms



Other Best Practices



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