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American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID‐19 Pandemic: Version 3
Author(s) -
Mikuls Ted R.,
Johnson Sindhu R.,
Fraenkel Liana,
Arasaratnam Reuben J.,
Baden Lindsey R.,
Bermas Bonnie L.,
Chatham Winn,
Cohen Stanley,
Costenbader Karen,
Gravallese Ellen M.,
Kalil Andre C.,
Weinblatt Michael E.,
Winthrop Kevin,
Mudano Amy S.,
Turner Amy,
Saag Kenneth G.
Publication year - 2021
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.41596
Subject(s) - pandemic , context (archaeology) , medicine , rheumatology , task force , family medicine , voting , delphi method , disease , covid-19 , medical education , infectious disease (medical specialty) , computer science , political science , artificial intelligence , public administration , politics , law , paleontology , biology
Objective To provide guidance to rheumatology providers on the management of adult rheumatic disease in the context of the coronavirus disease 2019 ( COVID ‐19) pandemic. Methods A task force, including 10 rheumatologists and 4 infectious disease specialists from North America, was convened. Clinical questions were collated, and an evidence report was rapidly generated and disseminated. Questions and drafted statements were reviewed and assessed using a modified Delphi process. This included asynchronous anonymous voting by email and webinars with the entire panel. Task force members voted on agreement with draft statements using a 1–9‐point numerical scoring system, and consensus was determined to be low, moderate, or high based on the dispersion of votes. For approval, median votes were required to meet predefined levels of agreement (median values of 7–9, 4–6, and 1–3 defined as agreement, uncertainty, or disagreement, respectively) with either moderate or high levels of consensus. Results Draft guidance statements approved by the task force have been combined to form final guidance. Conclusion These guidance statements are provided to promote optimal care during the current pandemic. However, given the low level of available evidence and the rapidly evolving literature, this guidance is presented as a “living document,” and future updates are anticipated.