Background
Assessment of the need for the RAG
WHO criteria for the need of a RAG | Explanation | Is this criterion met? | Reason |
---|---|---|---|
Whether the public health event is an emergency or dangerous situation | 1). Emergencies may be classified as natural, technological, or conflict related and may be of sudden onset (e.g., earthquakes, tsunamis, chemical crises) or more gradual onset (e.g., deteriorating situations in armed conflict, progressive disease outbreaks, drought, or food insecurities) 2). Using the rapid risk assessment of acute public health events manual to assess ‘‘any outbreak or other rapidly evolving situation that may have negative consequences for human health and requires immediate assessment and action’’ [13]. | Yes | On January 26, the WHO raised the global risk of the epidemic to "high risk" for the first time, with 2014 cases confirmed in 11 countries in the Americas, Oceania, Asia and Europe [14] |
Whether the public health event is novel | 1). A new public health event (e.g., emerging infectious disease) or an event encountered previously but causing problems in a different context 2). If the contingency is not the first of its kind and relevant high-quality guideline already exists, it can be adopted directly or adapted to quickly address the health concern. (e.g., Ebola outbreak in the Democratic Republic of the Congo again in 2019, but by this time high-quality Ebola guidelines have been published, so there is no need to develop rapid advice guidelines for Ebola [15, 16].) | Yes | On January 26, nucleic acid testing of the virus by Chinese researchers had revealed that the disease was caused by a novel coronavirus, that it was an outbreak of a new public health threat, and that there were no high-quality guidelines for children with this condition published at this time [17, 18] |
Duration of the public health event | The purpose of the RAG is to provide urgently needed evidence-based recommendations that should be implemented within one to three months, and if an event is likely to last more than six months, then a standard guide may be the best approach | Yes | The global SARS outbreak lasted almost 8 months from the first case to the complete eradication, the MERS outbreak has lasted 5 years, and SARS-CoV-2 belongs to the same coronavirus genus as SARS-CoV and MERS-CoV. COVID-19 epidemic can also be expected to last for some time, so it is feasible to develop rapid advice guidelines within 1 to 3 months of the outbreak [19] |
The need to urgently address the problem of uncertainty | In the event of a public health emergency, there is significant controversy among health care professionals about certain issues or aspects that need to be resolved in the short term. (e.g., the use of glucocorticoids in the treatment of COVID-19 disease faces considerable controversy. The WHO Expert Group on the Clinical Management of Novel Coronaviruses, J Kenneth Baillie et al. commented in the Lancet that clinical evidence does not support the use of glucocorticoids to treat lung injury caused by novel coronaviruses, and may even be harmful, while China's frontline antiviral experts suggest that glucocorticoids have some benefit [20, 21].) | Yes | After a systematic review of published guidelines, we found that most focused on the diagnosis, treatment and prevention of COVID-19 in adults, with little attention paid to special populations such as children. There is an urgent need for clinical guidance on antiviral treatment, clinical manifestations, diagnostic criteria and home management of children with mild or severe COVID-19 [22] |
Whether it can be rapidly and widely implemented | Before developing RAGs, it is important to consider the various factors involved in their implementation, such as the breadth and acceptability of the target population, their integration into national health policy systems, and their rapid implementation | Yes | SARS-CoV-2 is highly contagious and the entire population is susceptible. The total number of children in the world stands at 2 billion, and children, as a vulnerable group, are of great concern [23, 24]. In addition, countries threatened by the epidemic have elevated the prevention and control of COVID-19 to the highest national priority and have promulgated various health policies to prevent and control the disease [25], so that COVID-19 guidelines can be widely implemented |
Selection of development manuals
The methodology and experience from the development process
Formulation of the RAG Working Group
Declaration and management of conflicts of interest
Registration of the guideline and publication of the protocol
Collection and prioritization of clinical questions
No | Initial Questions (IQ) | Average score | Decision of inclusion; reason, remarks | Final Questions |
---|---|---|---|---|
IQ1 | What are the main symptoms of children infected with the novel coronavirus? | 6.33 | Yes. According to experts’ comments, we revised the wording of this clinical question | Clinical question 1: What are the symptoms of children with COVID-19 and who needs further assessment? |
IQ2 | What is confirmatory test for diagnosis novel coronavirus infection in children? | 6.19 | Yes. According to experts’ comments, we combined IQ2 and IQ8 into one question | Clinical question 3: Should computed tomography (CT) scan be used for the diagnosis and monitoring of children with COVID-19? |
IQ3 | How to conduct screening to novel coronavirus for suspected childhood infection in hospitals? | 6.17 | No. According to experts’ comments, this clinical question was not a priority in this phase | NA |
IQ4 | How to hierarchically manage children with novel coronavirus infection (including asymptomatic infected children)? | 5.96 | Yes. According to experts’ comments, the clinical question is answered in the form of a treatment pathway diagram | For the pathway diagram, please refer to the original maintext of the rapid advice guidelines for management of children with COVID-19 [10] |
IQ5 | How to effectively prevent children getting infected novel coronavirus? (Tips for protecting children from novel coronavirus infection)? | 5.96 | No. According to experts’ comments, this clinical question not belong to our guideline scope | NA |
IQ6 | Should new antiviral medications (such as lopinavir/ritonavir, remdesivir (GS-5734)) be used to treat in children with novel coronavirus infection? | 5.85 | Yes. According to experts’ comments, we combined IQ6 and IQ9 into one question and revised the wording | Clinical question 4: Should antiviral drugs such as ribavirin, interferon, remdesivir (GS-5734), lopinavir/ritonavir or oseltamivir be used to treat children with COVID-19? |
IQ7 | Should systemic corticosteroid be used to treat children with novel coronavirus infection? | 5.83 | Yes. According to experts’ comments, we revised the wording of this clinical question | Clinical question 6: Should systemic corticosteroids be used to treat children with severe COVID-19? |
IQ8 | Do children with non-severe novel coronavirus infection need imaging tests? | 5.69 | Yes. According to experts’ comments, we combined IQ2 and IQ8 into one question | Clinical question 3: Should computed tomography (CT) scan be used for the diagnosis and monitoring of children with COVID-19? |
IQ9 | Should traditional antiviral medications (such as ribavirin, interferon) be used to children with novel coronavirus infection? | 5.63 | Yes. According to experts’ comments, we combined IQ6 and IQ9 into one question | Clinical question 4: Should antiviral drugs such as ribavirin, interferon, remdesivir (GS-5734), lopinavir/ritonavir or oseltamivir be used to treat children with COVID-19? |
IQ10 | Where could parents and their children get reliable and evidence-based information about novel coronavirus epidemic and prevention? | 5.63 | Yes. According to experts’ comments, we revised the wording of this clinical question | Clinical question 10: How should parents be advised to get information on SARS-CoV-2 infection? |
IQ11 | How to manage a child who has history of epidemiological exposure but without symptoms? | 5.57 | Yes. According to experts’ comments, we combined IQ6 and IQ9 into one question | Clinical question 2: How should children who have had contact with COVID-19 patients be managed? |
IQ12 | Should IVIG be used to treat children with severe novel coronavirus severe infection? | 5.56 | Yes. According to experts’ comments, we revised the wording of this clinical question | Clinical question 7: Should intravenous immunoglobulin (IVIG) be used to treat children with severe COVID-19? |
IQ13 | For children with no history of epidemiological exposure, what are the indications or symptoms for screening novel coronavirus? | 5.37 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ14 | Should CT test be better than normal chest X-ray in children with severe novel coronavirus pneumonia? | 5.35 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ15 | What are the imaging features of children with novel coronavirus infection in lungs, are they specific? | 5.35 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ16 | How long is the average incubation period for children infected with novel coronavirus? | 5.31 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ17 | What is the severity for novel coronavirus infection in children compared to adults? | 5.15 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ18 | What is the prognosis of children with novel coronavirus infection? | 5.12 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ19 | How to conduct psychological assessment and therapy for children diagnosed with novel coronavirus infection? | 4.96 | Yes. We reached consensus that this clinical question was a priority issue for this guideline | Clinical question 8: What is appropriate supportive care for children with severe COVID-19? |
IQ20 | Could the novel coronavirus be vertically transmitted (mother to infant, breastfeeding)? If so, is there any difference in risk between natural delivery and caesarean section? | 4.94 | Yes. We reached consensus that this clinical question was a priority issue for this guideline | Clinical question 9: Should mothers with COVID-19 continue to breastfeed their babies? |
IQ21 | Should antibiotic agents be used to treat novel coronavirus infection? | 4.91 | Yes. According to experts’ comments, this clinical question was a priority issue for this guideline | Clinical question 5: Should antibiotics be used to treat children with COVID-19? |
IQ22 | What are the predisposing factors (gender, age, underlying diseases, ethnic differences) for novel coronavirus infection in children? | 4.85 | No. According to experts’ comments, this clinical question was not a priority issue for this guideline | NA |
IQ23 | Does the complete blood count (CBC) test for children with early 2019-nCoV infection have a predictive effect on the severity of the disease? | 4.85 | No. According to experts’ comments, this clinical question was not a priority issue for this guideline | NA |
IQ24 | Could a multidisciplinary cooperation improve the outcomes for children with severe novel coronavirus infection? | 4.62 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ25 | How susceptible are children compared to adults for novel coronavirus? | 4.33 | No. We reached consensus that this clinical question was not a priority issue for this guideline | NA |
IQ26 | What is the severity for 2019-nCoV infection in children (e.g., mortality and ICU admission rates) compared to SARS/MERS? | 4.28 | No. We members reached consensus that this clinical question was not a priority issue for this guideline | NA |
Evidence retrieval, assessment and synthesis
Questions | Rapid review(s) to answer the questions | Studies included in the rapid review | Was the recommendation fully supported by evidence from COVID-19 (Yes/Partially/No) | Was the recommendation fully supported by evidence from children with COVID-19 (Yes/Partially /No) | Proportion of preprints in the COVID-19 studies per rapid review |
---|---|---|---|---|---|
Clinical question 1: what are the symptoms of children with COVID-19 and who needs further assessment? | One rapid review (produced by RRG) | Wang Z et al., 2020 [45] Number of primary studies: 49 Study design: 25 case reports, 23 case series and one cohort study Patients: All patients are children with COVID-19 Sources: Seven preprints, 42 journal articles | Yes, 100% | Yes, 100% | 14.3% (7/49) |
Clinical question 2: how should children who have had contact with COVID-19 patients be managed? | Three rapid reviews(two rapid reviews produced by RRG, one published article) | Gao Y et al., 2020 [46] Number of primary studies:9 Study design: 9 cross-sectional studies Patients: One article was about COVID-19 (all patients were adults), eight articles were about SARS Sources: Zero preprint, 9 journal articles | Partially, 11% | No, 0% | 0.0%(0/4) |
Zhou Q et al., 2020 [47] Number of primary studies: 40 Study design: Nine case series, 30 cross-sectional studies and one case–control Patients: Four articles were about adults with COVID-19, 25 articles were about SARS, 11 articles were about MERS Sources: Zero preprint, 40 journal articles | Partially, 10% | No, 0% | 0.0%(0/1) | ||
Nussbaumer-Streit B et al., 2020 [57] Number of primary studies:29 Study design: Four cohort studies and 25 modelling studies Patients: 10 articles were about COVID-19 (almost patients were adults), 15 articles were about SARS, two articles were about MERS and two articles were about SARS and other infectious diseases Sources: Zero preprint, 28 journal articles and one unpublished report | Partially, 34% | No, 0%* | 0.0%(0/10) | ||
Clinical question 3: should computed tomography (CT) scan be used for the diagnosis and monitoring of children with COVID-19? | One rapid review (produced by RRG) | Lv M et al., 2020 [48] Number of primary studies: 103 Study design: 82 case series and 21 case reports Patients: All articles were about COVID-19, 7 articles were only included children, other articles were included adults Sources: Five preprints, 98 journal articles | Partially, 100% | Partial, 6.8%a | 4.8%(5/103) |
Clinical question 4: should antiviral drugs such as ribavirin, interferon, remdesivir (GS-5734), lopinavir/ritonavir or oseltamivir be used to treat children with COVID-19? | One rapid review (produced by RRG) | Shi Q et al., 2020 [49] Number of primary studies: 23 Study design: Six randomized controlled trials and 17 cohort studies Patients: Seven articles were about COVID-19 (almost patients were adults), 13 articles were about SARS, three articles were about MERS Sources: Three preprints, 20 journal articles | Partially, 30% | No, 0%a | 42.9%(3/7) |
Clinical question 5: should antibiotics be used to treat children with COVID-19? | One rapid review (produced by RRG) | Wang J et al., 2020 [50] Number of primary studies: Six Study design: Five case series and one cohort study Patients: Five articles were about SARS and one article was about MERS Sources: Zero preprint, six journal articles | No, 0% | No, 0% | NA |
Clinical question 6: should systemic corticosteroids be used to treat children with severe COVID-19? | One rapid review (produced by RRG) | Lu S et al., 2020 [51] Number of primary studies: 23 Study design: One randomized controlled trial and 22 cohort studies Patients: Five articles were about COVID-19 (all patients were adults), 17 articles were about SARS and one article was about MERS Sources: Two preprints, 21 journal articles | Partially, 22% | No, 0% | 40.0% (2/5) |
Clinical question 7: should intravenous immunoglobulin (IVIG) be used to treat children with severe COVID-19? | One rapid review (produced by RRG) | Zhang J et al., 2020 [52] Number of primary studies: Six Study design: One randomized controlled trial, four case series and one case report Patients: Two articles were about COVID-19 (all patients were adults) and four articles were about SARS Sources: One preprint, five journal articles | Partially, 33% | No, 0% | 50.0% (1/2) |
Clinical question 8: what is appropriate supportive care for children with severe COVID-19? | One umbrella review (produced by RRG) | Luo X et al., 2020 [53] Number of primary studies: 18 Study design: 18 systematic reviews Patients: 18 articles were not about COVID-19, SARS and MERS Sources: Zero preprint, 18 journal articles | No, 0% | No, 0% | NA |
Clinical question 9: should mothers with COVID-19 continue to breastfeed their babies? | Two rapid reviews (one rapid review produced by RRG, one previously published article) | Yang N et al., 2020 [54] Number of primary studies: Six Study design: Five case reports and one case series Patients: Five articles were about COVID-19 (all patients were mothers) and one article was influenza Sources: Zero preprint, six journal articles | Partially, 83% | No, 0% | 0.0% (0/5) |
Jefferson T et al., 2011 [59] Number of primary studies: 67 Study design: Six randomized controlled trials, 17 non-randomized controlled trials, nine case–control studies, 22 cohort studies and 13 before-after controlled studies Patients: 67 articles were not about COVID-19 and MERS Sources: Six journal articles | No, 0% | No, 0% | NA | ||
Clinical question 10: how should parents be advised to get information on SARS-CoV-2 infection? | One rapid review (produced by RRG) | Li W et al., 2020 [55] Number of primary studies: 24 Study design: 24 cross-sectional studies Patients: Six articles were about COVID-19 (almost patients were adults), eight articles were about SARS, ten articles were about MERS Sources: Zero preprint, 24 journal articles | Partially, 25% | No, 0%a | 0.0% (0/6) |
Formulation of recommendations
First Round Delphi Process (results from 33 panelists) | Second Round Delphi Process (results from 30 panelists) | |||||||
---|---|---|---|---|---|---|---|---|
Preliminary recommendation (1st round) | Level of agreement | How many panelists gave comments | Total number of comments | Preliminary recommendation (2nd round) | Level of Agreement | How many panelists gave comments | Total number of comments | |
CQ1 | The main symptoms of children with COVID-19 are fever and cough. The symptoms of COVID-19 are usually less severe in children than adults. Leukocyte and lymphocyte counts are usually normal. Chest imaging findings do not significantly differ between adults and children. (2C) | 94% (Consensus) | 10 | 11 | The main symptoms of children with COVID-19 are fever and cough. The symptoms of COVID-19 are usually less severe in children than adults. Leukocyte and lymphocyte counts are usually normal. Although there is no significant difference between adults and children in chest imaging characteristics, the extend of the abnormalities are usually less in children. (2C) | NA | 8 | 11 |
CQ2 | We recommend that children who have been in close contact with COVID-19 patients are initially evaluated by their guardians or family doctors. If no obvious symptoms are found, we recommend staying at home for observation; if there are obvious symptoms such as fever and cough, we recommend further evaluation in the hospital. (2C) | 94% (Consensus) | 9 | 11 | We suggest that children who have been in close contact with COVID-19 patients are initially evaluated by their guardians or family doctors. If no obvious symptoms occur, we recommend staying at home for observation for a duration of at least 14 days; if there are obvious symptoms, we suggest further evaluation in the hospital. (2C) | NA | 9 | 12 |
CQ3 | We recommend X-ray rather than CT to assist in diagnosis of COVID-19 in children if necessary. (2C) | 55% (Not consensus) | 13 | 16 | We suggest not using imaging test as routine examination for children with COVID-19. (2C) | 79% (Consensus) | 11 | 13 |
CQ4 | We recommend against using antiviral drugs for children with COVID-19. Specific antiviral drugs may be administered only in the context of clinical trial (1C) | 94% (Consensus) | 7 | 9 | We recommend against using antiviral drugs for children with COVID-19. Specific antiviral drugs may be administered only in the context of clinical trial. (1C) | NA | 4 | 7 |
CQ5 | We recommend against the use of antibiotic agents for children with COVID-19 when there is no evidence of bacterial coinfection. (1B) | 100% (Consensus) | 2 | 3 | We recommend against using antibiotic agents for children with COVID-19 when there is no evidence of bacterial coinfection. (1B) | NA | 1 | 1 |
CQ6 | We recommend using systemic glucocorticoids with a low dose and for a short duration for children with severe COVID-19. (2C) | 79% (Consensus)a | 12 | 12 | 1) We recommend against using systemic glucocorticoids for children with COVID-19 routinely (1C) 2) We suggest a low dose and a short duration for severe COVID-19 children only when over inflammatory reaction or in the context of clinical trials. (2D) | 100% (Consensus) 93% (Consensus) | 11 | 13 |
CQ7 | We recommend against the use of intravenous immunoglobulin (IVIG) in the treatment of children with severe COVID-19. (1B) | 88% (Consensus) | 2 | 2 | We recommend against using intravenous immunoglobulin (IVIG) for children with severe COVID-19. (1B) | NA | 6 | 6 |
CQ8 | We propose the following forms of supportive care for children with severe COVID-19: 1) ensuring sufficient number of adequate medical staff in ICUs; 2) systematically monitoring and recording vital signs; 3) using supportive care of the respiratory and cardiovascular symptoms according to clinical needs; 4) providing psychological therapy for children with severe COVID-19 | 97% (Consensus) 100% (Consensus) 100% (Consensus) 88% (Consensus) | 9 | 9 | We propose the following forms of supportive care for children with severe COVID-19: 1) ensuring sufficient number of adequate medical staff in ICUs; 2) systematically monitoring and recording vital signs; 3) using supportive care of the respiratory and cardiovascular symptoms according to clinical needs; 4) providing psychological interventions | NA | 5 | 5 |
CQ9 | We do not recommend interrupting breastfeeding except for mothers with severe COVID-19 | 72% (Consensus) | 15 | 17 | We recommend against mothers interrupting breastfeeding. (2C) | NA | 7 | 7 |
CQ10 | 1)We recommend parents to arrange national and international travel with caution during the SARS-CoV-2 epidemic, and follow the epidemiological situation in their travel destination(1D); 2)We recommend parents to obtain information from print media, authorities and official agencies rather than social media(1D) 3)We recommend parents to provide their children with suitable health education to improve the awareness on infectious diseases and teach their children not to discriminate people from areas affected by the epidemic 1D) | 94% (Consensus) | 8 | 14 | We recommend parents to obtain information regularly from academic and official resources rather than social media. (1D) | NA | 2 | 2 |
Draft of RAG and external review
Task | Planned date of completion (day) | Actual date of completion (day) | Excess time spent (days) |
---|---|---|---|
Start to work | Jan 28-Jan 28 (One day) | Jan 28-Jan 28 (One day) | 0 |
Write protocol | Jan 29-Jan 29 (One day) | Jan 29-Feb 3 (Six days) | 5 |
Invite panelists | Jan 30-Feb 2 (Four days) | Jan 29-Feb 3 (Six days) | 2 |
Declare conflicts of interests | Jan 30-Feb 2 (Four days) | Jan 30-Feb 5 (Four days) | 0 |
Register guideline | Feb 1-Feb 1 (One day) | Feb 1-Feb 1 (One day) | 0 |
Propose clinical questions | Feb 2-Feb 2 (One day) | Jan 29-Feb 2 (Five days) | 4 |
Select clinical questions | Feb 3-Feb 4 (Two days) | Feb 3-Feb 6 (Four days) | 2 |
Identify PICO clinical questions | Feb 5-Feb 5 (One day) | Feb 7-Feb 15 (Nine days) | 8 |
Retrieve existing systematic reviews | Feb 6-Feb 6 (One day) | Feb 16-Feb 16 (One day) | 0 |
Conduct rapid reviewa | Feb 7-Feb 11 (Five days) | Feb 11-Feb 15(Five days) | 0 |
GRADE evidence | Feb 12-Feb 12 (One day) | Feb 17-Feb 17 (One day) | 0 |
Draft recommendations | Feb 13-Feb 13 (One day) | Feb 18-Feb 23 (Six days) | 5 |
Conduct the 1st round of Delphi survey | Feb 14-Feb 16 (Three days) | Feb 24-Feb 27 (Four days) | 1 |
Conduct the 2ed round of Delphi survey | Feb 17-Feb 19 (Three days) | Feb 28-Mar 1 (Three days) | 0 |
Reach recommendations | Feb 20-Feb 21 (Two days) | Mar 2-Mar 3 (Two days) | 0 |
Draft full guideline | Feb 22-Feb 22 (One day) | Mar 4-Mar 6 (Three days) | 2 |
Send to external reviewers | Feb 23-Feb 24 (Two days) | Mar 6-Mar 15 (Ten days) | 8 |
Revise the guideline | Feb 25-Feb 25 (One day) | Mar 11-Mar 16 (Six days) | 5 |
Submit to medical journal | Feb 26-Feb 26 (One day) | Mar 17 (One day) | 0 |
Accepted by journal | NA | 6-May | NA |
Number of meetings | Meeting Date | Duration (h) | Participants (number of attendances) | Main Contents of the Meeting | The form of the meeting |
---|---|---|---|---|---|
1st | Feb-1 (14:30–17:15) | 2.75 | CM (4), MRRG (22) | 1) Selection of the members of expert group 2) Discussion and optimization of initial clinical questions 3) Pre-preparation for the first round of clinical questions (preparation of materials, identification of leaders) | Teleconference – QQ |
2nd | Feb-6 (10:30–11:30) | 1.0 | CM (4), MRRG (20) | 1) Feedback from the first round of clinical questions and expert opinion are discussed 2) Preparation of research materials for the second round of clinical questions | Teleconference – QQ |
3rd | Feb-7 (16:30–17:30) | 1.0 | CM (4), MRRG (8) | 1) Discussion of late arrangements 2) Identification of final key clinical questions | Teleconference – QQ |
4th | Feb-11 (8:30–9:00) | 0.5 | CM (2), MRRG (24) | 1) Discussion of the process of conducting rapid review 2) Identification of search strategies for each clinical question | Teleconference – QQ |
5th | Feb-15 (15:00–18:00) | 3.0 | CM (4), MRRG (22) | 1) Discussion of preliminary evidence search results for each clinical question 2) Discussion of preliminary evidence summary 3) Adjustments to the search strategy for several clinical questions (supplementing other indirect evidence) | Teleconference – QQ |
6th | Feb-17 (19:00–22:30) | 3.5 | CM (5), MRRG (24) | 1) Discussion of the results of the updated evidence summary 2) Discussion of the results of the adjusted evidence search for clinical questions 3) Drafted recommendations based on evidence summary | Teleconference – QQ |
7th | Feb-18 (20:10–22:55) | 2.75 | CM (5) | 1) Modified the evidence summary expression and elaboration for each clinical question 2) Revision of the content of the recommendation | Teleconference – WeChat |
8th | Feb-19 (17:00–18:00) | 1.0 | CM (6), MRRG (10) | 1) Modified the evidence summary expression and elaboration for each clinical question 2) Revision of the content of the recommendation | Teleconference – QQ |
9th | Feb-20 (14:00–18:45) | 4.75 | CM (5), MRRG (24) | 1) Modified the evidence summary expression and elaboration for each clinical question 2) Revision of the content of the recommendation 3) Preparation of questionnaire materials for the first round of Delphi survey | Teleconference – QQ |
10th | Feb-21 (11:00–11:30) | 0.5 | CM (5) | 1) Revision of the wording of the recommendation and evidence summary 2) Revision of the first round of Delphi questionnaire materials | Teleconference – WeChat |
11th | Feb-26 (19:00–22:45) | 3.75 | CM (5), MRRG (23) | 1) Discussed the comments from the first round of Delphi survey one by one and revised the content of the recommendations 2) Responded to expert comments and produced feedback report 3) Preparation of questionnaire materials for the second round of Delphi survey | Teleconference – QQ |
12th | Feb-29 (9:00–12:00) | 3.0 | CM (5), MRRG (23) | 1) Improved the content of the evidence summary and rationale section 2) Standardizing the format and wording of written content | Teleconference – QQ |
13th | Feb-29 (14:00–16:00) | 2.0 | CM (5), MRRG (23) | 1) Improved the content of the evidence summary and rationale section 2) Standardizing the format and wording of written content | Teleconference – QQ |
14th | Mar-2 (18:00–19:00) | 1.0 | CM (6) | 1) Discussed the comments from the second round of Delphi one by one and revised the content of the recommendations 2) Responded to expert comments and produced feedback report 3) Discussion of late arrangements (drafting the full guideline) | Teleconference – QQ |
15th | Mar-2 (20:00–21:30) | 1.5 | CM (5) | 1) Revision of the content of the recommendations for each clinical question | Teleconference –WeChat |
16th | Mar-3 (21:00–22:15) | 1.25 | CM (5) | 1) Revision of the content of the recommendations for each clinical question | Teleconference –WeChat |
17th | Mar-4 (18:00–20:15) | 2.25 | CM (5) | 1) Revision of the guidelines based on expert comments 2) Drafting of the full text of the RAG | Teleconference – QQ |
18th | Mar-5 (19:00–20:00) | 3.0 | CM (5), MRRG (10) | 1) Revision of the guidelines based on expert comments | Teleconference – QQ |
19th | Mar-6 (17:00–20:00) | 5.0 | CM (6) | 1) Identification of journals for submission 2) Identification of external reviewers 3) Revision of the guidelines based on expert comments | Teleconference – QQ |
20th | Mar-7 (13:20–15:20) | 2.0 | CM (3), MRRG (10) | 1) Discussed 11 rapid reviews (full text) | Teleconference – QQ |
21st | Mar-7 (19:15–21:45) | 2.5 | CM (5) | 1) Revision of the guidelines based on external reviewers’ comments | Teleconference – WeChat |
Total | NA | 48 | 347 | NA | NA |
Average | NA | 2.29 ± 1.30 | 16.5 ± 10.0 | NA | NA |