e-Article
The Penn Medicine COVID-19 Therapeutics Committee-Reflections on a Model for Rapid Evidence Review and Dynamic Practice Recommendations During a Public Health Emergency
Document Type
Academic Journal
Author
Anesi, George L.; Degnan, Kathleen; Dutcher, Lauren; Saw, Stephen; Maguire, Christina; Binkley, Amanda; Patel, Sonal; Athans, Vasilios; Barton, Todd D.; Binkley, Shawn; Candeloro, Christina L.; Herman, David J.; Kasbekar, Nishaminy; Kennedy, Leigh; Millstein, Jeffrey H.; Meyer, Nuala J.; Talati, Naasha J.; Patel, Hinal; Pegues, David A.; Sayre, Patrick J.; Tebas, Pablo; Terico, Adrienne T.; Murphy, Kathleen M.; O'Donnell, Judith A.; White, Melissa; Hamilton, Keith W.
Source
Open Forum Infectious Diseases. August 2023, Vol. 10 Issue 8
Subject
Language
English
ISSN
2328-8957
Abstract
As the United States anxiously awaited the arrival of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, clinicians and researchers began a frantic search for guidance in how to [...]
The Penn Medicine COVID-19 Therapeutics Committee-an interspecialty, clinician- pharmacist, and specialist-front line primary care collaboration-has served as a forum for rapid evidence review and the production of dynamic practice recommendations during the 3-year coronavirus disease 2019 public health emergency. We describe the process by which the committee went about its work and how it navigated specific challenging scenarios. Our target audiences are clinicians, hospital leaders, public health officials, and researchers invested in preparedness for inevitable future threats. Our objectives are to discuss the logistics and challenges of forming an effective committee, undertaking a rapid evidence review process, aligning evidence-based guidelines with operational realities, and iteratively revising recommendations in response to changing pandemic data. We specifically discuss the arc of evidence for corticosteroids; the noble beginnings and dangerous misinformation end of hydroxychloroquine and ivermectin; monoclonal antibodies and emerging viral variants; and patient screening and safety processes for tocilizumab, baricitinib, and nirmatrelvir-ritonavir. Keywords. COVID-19; emerging pathogen; evidence-based medicine; preparedness.
The Penn Medicine COVID-19 Therapeutics Committee-an interspecialty, clinician- pharmacist, and specialist-front line primary care collaboration-has served as a forum for rapid evidence review and the production of dynamic practice recommendations during the 3-year coronavirus disease 2019 public health emergency. We describe the process by which the committee went about its work and how it navigated specific challenging scenarios. Our target audiences are clinicians, hospital leaders, public health officials, and researchers invested in preparedness for inevitable future threats. Our objectives are to discuss the logistics and challenges of forming an effective committee, undertaking a rapid evidence review process, aligning evidence-based guidelines with operational realities, and iteratively revising recommendations in response to changing pandemic data. We specifically discuss the arc of evidence for corticosteroids; the noble beginnings and dangerous misinformation end of hydroxychloroquine and ivermectin; monoclonal antibodies and emerging viral variants; and patient screening and safety processes for tocilizumab, baricitinib, and nirmatrelvir-ritonavir. Keywords. COVID-19; emerging pathogen; evidence-based medicine; preparedness.