2024 RECOVER Guidelines: Methods, evidence identification, evaluation, and consensus process for development of treatment recommendations

Author:

Fletcher Daniel J.1ORCID,Boller Manuel23,Burkitt‐Creedon Jamie M.4ORCID,Fausak Erik5,Van Noord Megan G.5,Mears Kim6,Hopper Kate4,Epstein Steven E.4ORCID

Affiliation:

1. Department of Clinical Sciences, College of Veterinary Medicine Cornell University Ithaca New York USA

2. VCA Canada Central Victoria Veterinary Hospital Victoria British Columbia Canada

3. Faculty of Veterinary Medicine, Department of Veterinary Clinical and Diagnostic Sciences University of Calgary Calgary Alberta Canada

4. Department of Surgical and Radiological Sciences, School of Veterinary Medicine University of California, Davis Davis California USA

5. University Library University of California Davis Davis California USA

6. Robertson Library University of Prince Edward Island Charlottetown Prince Edward Island Canada

Abstract

AbstractObjectiveTo describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to re‐evaluate the scientific evidence relevant to CPR in small and large animals, to newborn resuscitation, and to first aid and to formulate the respective consensus‐based clinical guidelines.DesignThis report describes the evidence‐to‐guidelines process employed by RECOVER that is based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and includes Information Specialist‐driven systematic literature search, evidence evaluation conducted by more than 200 veterinary professionals, and provision of clinical guidelines in the domains of Preparedness and Prevention, Basic Life Support, Advanced Life Support, Post‐cardiac Arrest Care, Newborn Resuscitation, First Aid, and Large Animal CPR.SettingTransdisciplinary, international collaboration in academia, referral practice, and general practice.ResultsFor this update to the RECOVER 2012 CPR guidelines, we answered 135 Population, Intervention, Comparator, and Outcome (PICO) questions with the help of a team of Domain Chairs, Information Specialists, and more than 200 Evidence Evaluators. Most primary contributors were veterinary specialists or veterinary technician specialists. The RECOVER 2024 Guidelines represent the first veterinary application of the GRADE approach to clinical guideline development. We employed an iterative process that follows a predefined sequence of steps designed to reduce bias of Evidence Evaluators and to increase the repeatability of the quality of evidence assessments and ultimately the treatment recommendations. The process also allowed numerous important knowledge gaps to emerge that form the foundation for prioritizing research efforts in veterinary resuscitation science.ConclusionsLarge collaborative, volunteer‐based development of evidence‐ and consensus‐based clinical guidelines is challenging and complex but feasible. The experience gained will help refine the process for future veterinary guidelines initiatives.

Funder

Boehringer Ingelheim Animal Health

Publisher

Wiley

Reference20 articles.

1. RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 7: clinical guidelines: RECOVER clinical guidelines;Fletcher DJ;J Vet Emerg Crit Care,2012

2. RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 1: evidence analysis and consensus process: collaborative path toward small animal CPR guidelines;Boller M;J Vet Emerg Crit Care,2012

3. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations;Guyatt GH;BMJ,2008

4. The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review;Eriksen MB;J Med Libr Assoc JMLA,2018

5. Librarian co‐authored systematic reviews are associated with lower risk of bias compared to systematic reviews with acknowledgement of librarians or no participation by librarians;Aamodt M;Evid Based Libr Inf Pract,2019

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