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Broad and specific decisions
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Criteria for 'best evidence synthesis' |
Details to support relevance assessment |
Additional decision-relevant details |
Citation |
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Quality (AMSTAR) rating
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Evidence profile |
Key findings
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Living evidence synthesis |
Type of synthesis |
Type of question
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Approach
to population-health management for COVID-19 and for those whose care is
disrupted by COVID-19
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Segmenting the population into groups with shared health and
social needs
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Re-designing care pathways and in-reach and out-reach services |
2020-03-30 |
2/9 |
No |
Surgeries should be posponed during the pandemic when feasible to reduce risk of infection and complications, while health personnel should carefully manage the use of operating theatres, and involve the smallest number of staff for emergency or necessary surgeries
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No |
Full review |
Other |
De Simone B, Chouillard E, Di Saverio S, et al. Emergency Surgery During the COVID-19 Pandemic: What You Need to Know for Practice. Ann R Coll Surg Engl 2020;102(5):323-332.
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Addressing barriers to implementation of pathways and services
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Addressing cultural safety in the implementation of pathways and
services
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Maintaining gains made in population-health management (e.g.,
population segmentation, virtual care) and spreading and scaling them
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Delivery arrangements
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Service
planning for COVID-19 prevention
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Changing emergency-medical service procedures (ambulances,
paramedics)
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Re-locating hospital-based ambulatory clinics, cancer
treatments, etc.
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Limiting access to health facilities
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Changing hospital-discharge procedures
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Changing long-term care procedures
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2020-05-29
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7/10 |
Yes |
Outbreak investigations show that long-term care facilities are more vulnerable to the COVID-19 pandemic, in terms of disease spread and mortality rate |
Yes |
Full review |
Other |
Salcher-Konrad M, Jhass A, Naci H, Tan M, El-Tawil Y, Comas-Herrera A. COVID-19 Related Mortality and Spread of Disease in Long-Term Care: First Findings from a Living Systematic Review of Emerging Evidence. MedRxiv 2020. |
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Changing home and community care procedures
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Service
planning for COVID-19 treatment
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Scaling up/down testing capacity
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Scaling up/down emergency-room capacity
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Scaling up/down ICU capacity
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2020-03-30
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2/9 |
No |
Decisions to perform surgery should be carefully evaluated based on availability of ICU capacity in contexts where operational theatres have been converted into temporary ICUs for COVID-19 patients |
No |
Full review |
Other |
De Simone B, Chouillard E, Di Saverio S, et al. Emergency Surgery During the COVID-19 Pandemic: What You Need to Know for Practice. Ann R Coll Surg Engl 2020;102(5):323-332. |
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Scaling up/down post-ICU recovery capacity (e.g., hospital beds)
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Scaling up/down palliative-care capacity
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Scaling up/down COVID-19 sequelae-management capacity
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Scaling up/down capacity to manage the pandemic-related impacts
on health more generally (e.g., mental health and addictions)
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Surge-management models
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Triage protocols
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2020-03-30 |
2/9 |
No |
The use of triage protocols can support assessments of patient severity and help to decide whether surgery is necessary or can be delayed with non-surgical management during the COVID-19 pandemic |
No |
Full review |
Other |
De Simone B, Chouillard E, Di Saverio S, et al. Emergency Surgery During the COVID-19 Pandemic: What You Need to Know for Practice. Ann R Coll Surg Engl 2020;102(5):323-332. |
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2020-03-26
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7/9 |
Yes |
Key factors affecting adherence to infection prevention and control guidelines among healthcare workers include their design and content, how they are communicated, and whether there is adequate organizational support, training, and access to personal prot |
No |
Rapid review |
Other |
Houghton C, Meskell P, Delaney H, et al. Barriers and Facilitators to Healthcare Workers' Adherence with Infection Prevention and Control (IPC) Guidelines for Respiratory Infectious Diseases: a Rapid Qualitative Evidence Synthesis. Cochrane Database Syst Rev 2020;4(4):CD013582. |
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Infection prevention and control measures in health facilities
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2020-04-01
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9/10 |
No |
It is uncertain whether facial barriers alone are effective without other measures to reduce the spread of respiratory viruses |
No |
Full review |
Benefits and harms |
Jefferson T, Jones M, Al Ansari L, Bawazeer G, Beller E, Clark J, et al. Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses. Part I - Face Masks, Eye Protection and Person Distancing: Systematic Review and Meta-Analysis. MedRxiv 2020. |
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2020-04-24
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6/10 |
No |
No use of PPE by healthcare workers (including masks, gloves, gowns and eye protection) is consistently associated with an increasing risk of corinavirus infection |
Yes |
Full review |
Benefits and harms |
Chou R, Dana T, Buckley D, Selph S, Fu R, Totten A. Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med 2020; M20-1632. |
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2020-04-02
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5/9 |
No |
The risk of contracting SARS-Cov-2 through surgical smoke cannot be excluded, so healthcare personnel need to adopt all required protective strategies, including preoperative testing |
No |
Full review |
Other |
Pavan N, Crestani A, Abrate A, et al. Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive Surgery: A Systematic Review of Literature on a Neglected Issue Revived in the COVID-19 Pandemic Era. Eur Urol Focus. 2020;S2405-4569(20)30156-5. |
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Death certification
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Handling dead bodies
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Service
planning for the ongoing management of other conditions
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Changing acute care surgery and trauma-care procedures
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2020-03-30
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2/9 |
No |
Emergency surgeons need to maintain a high standard of care through assessments of surgical necessity and oversight of the implementation of risk-prevention measures in the operating theatre |
No |
Full review |
Other |
De Simone B, Chouillard E, Di Saverio S, et al. Emergency Surgery During the COVID-19 Pandemic: What You Need to Know for Practice. Ann R Coll Surg Engl 2020;102(5):323-332. |
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Changing cancer-treatment procedures
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2020-04-17
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6/9 |
No |
There is consistency among urology guidelines that certain services can be postponed, including for low-risk cancers |
No |
Full review |
Other |
Heldwein FL, Loeb S, Wroclawski ML, et al. A Systematic Review on Guidelines and Recommendations for Urology Standard of Care During the COVID-19 Pandemic. Eur Urol Focus. 2020;S2405-4569(20)30155-3. |
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Delaying return visits, elective procedures, etc.
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2020-03-30
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2/9 |
No |
Emergency surgeons should complete a comprehensive risk assessment when deciding whether to postpone surgical procedures |
No |
Full review |
Other |
De Simone B, Chouillard E, Di Saverio S, et al. Emergency Surgery During the COVID-19 Pandemic: What You Need to Know for Practice. Ann R Coll Surg Engl 2020;102(5):323-332. |
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2020-04-17
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6/9 |
No |
There is consistency among urology guidelines that certain services can be postponed, including for low-risk endourological conditions |
No |
Full review |
Other |
Heldwein FL, Loeb S, Wroclawski ML, et al. A Systematic Review on Guidelines and Recommendations for Urology Standard of Care During the COVID-19 Pandemic. Eur Urol Focus. 2020;S2405-4569(20)30155-3. |
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Infrastructure
planning and resource allocation
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Personal protective equipment (under shortage conditions),
including N95 respirators for health workers
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Ventilators for sick COVID-19 patients
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Medications and other technologies (under shortage conditions
due to disrupted supply chains)
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Remote monitoring
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2020-04-30 |
4/9 |
No |
Patients who have received respiratory rehabilitation and have ongoing complications as a result of COVID-19 may require telemonitoring during the post-acute phase of their illness |
Yes |
Full review |
Other |
de Sire A, Andrenelli E, Negrini F, Negrini S, Ceravolo M. Systematic Rapid Living Review on Rehabilitation Needs Due to Covid-19: Update to April 30th 2020. Eur J Phys Rehabil Med 2020. |
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Virtual visits
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2020-04-30
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4/9 |
No |
Patients who have received respiratory rehabilitation and have ongoing complications as a result of COVID-19 may require telerehabilitation during the post-acute phase of their illness |
Yes |
Full review |
Other |
de Sire A, Andrenelli E, Negrini F, Negrini S, Ceravolo M. Systematic Rapid Living Review on Rehabilitation Needs Due to Covid-19: Update to April 30th 2020. Eur J Phys Rehabil Med 2020. |
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Workforce
planning (including workforce shortages management) and development
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Recruitment
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Role extensions
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Training in new procedures
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Replacements when sick
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Movement-control strategies
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Supports to unpaid caregivers
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Volunteer engagement to support vulnerable populations
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Self-management supports
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Service
planning for ‘return to normal’
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Sequencing of services re-starting, by sector, conditions,
treatments (including diagnostics), and populations
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Wait-lists management
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Financial arrangements
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Financing
health services
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Funding
organizations
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Remunerating
providers
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New or adjusted fee codes for virtual care
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Income replacement when virtual care is not possible (at the
same scale)
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Purchasing
products and services
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Bulk purchasing
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Governance arrangements (who can make what decisions)
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Consumer
and stakeholder involvement
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Professional
authority
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Licensure changes to accommodate out-of-jurisdiction or retired
health workers
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Commercial
authority
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Technology approvals, public-private partnerships
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Organizational
authority
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Limits of number of staff sent in
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Policy
authority
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Federal versus provincial
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Adhering to the International Health Regulations
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