Exploring the concordance of recommendations across guidelines on chest imaging for the diagnosis and management of COVID-19: A proposed methodological approach based on a case study

Abstract

Objective To describe a methodological approach to explore the concordance of recommendations across guidelines and its application to the case of the WHO recommendations on chest imaging for the diagnosis and management of COVID-19. Study design and setting We followed a methodological approach applied to a case study that included: defining the 'reference guideline' (i.e., the WHO guidance) and the 'reference recommendations'; searching for 'related guidelines' and identifying 'related recommendations'; constructing the PICO for the recommendations; assessing the matching of the PICO of each related recommendation to the PICO corresponding reference recommendation; and assessing the concordance between the PICO-matching recommendations. Results We identified a total of 89 related recommendations from 22 related guidelines. Out of the 89 related recommendations, 43 partly matched and 1 entirely matched one of the reference recommendations, and out of these, 8 were concordant with one of the reference recommendations. When considering the seven reference recommendations, they had a median of 12 related recommendations (range 3-17), a median of 7 PICO-matching recommendations (range 0-13), and a median of 1 concordant recommendation (range 0-4). Conclusion Following a detailed methodological approach, we were able to explore the concordance between our reference recommendations and related recommendations from other guidelines. A relatively low percentage of recommendations was concordant.