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Record W3046832661 · doi:10.1136/bmj.m2924

Remdesivir for severe covid-19: a clinical practice guideline

2020· article· en· W3046832661 on OpenAlexaff
Bram Rochwerg, Arnav Agarwal, Linan Zeng, Yee‐Sin Leo, John Adabie Appiah, Thomas Agoritsas, Jessica J Bartoszko, Romina Brignardello‐Petersen, Begüm Ergan, Long Ge, Heike Geduld, Hayley B. Gershengorn, Hela Manai, Minhua Huang, François Lamontagne, Seema Kanda, Letícia Kawano-Dourado, Linda M. Kurian, Arthur Kwizera, Srinivas Murthy, Nida Qadir, Reed Siemieniuk, Maria Asuncion A. Silvestre, Per Olav Vandvik, Zhikang Ye, Dena Zeraatkar, Gordon Guyatt

Bibliographic record

VenueBMJ · 2020
Typearticle
Languageen
FieldMedicine
TopicCOVID-19 Clinical Research Studies
Canadian institutionsCentre Hospitalier Universitaire de SherbrookeUniversity of TorontoMcMaster UniversityUniversity of British ColumbiaImpact
Fundersnot available
KeywordsGuidelineMedicineClinical trialCoronavirus disease 2019 (COVID-19)MEDLINEIntensive care medicineRandomized controlled trialClinical PracticeHealth careFamily medicineSurgeryInternal medicinePathologyDisease

Abstract

fetched live from OpenAlex

CLINICAL QUESTION: on 22 May 2020. CURRENT PRACTICE: Remdesivir has received worldwide attention as a potentially effective treatment for severe covid-19. After rapid market approval in the US, remdesivir is already being used in clinical practice. RECOMMENDATIONS: The guideline panel makes a weak recommendation for the use of remdesivir in severe covid-19 while recommending continuation of active enrolment of patients into ongoing randomised controlled trials examining remdesivir. HOW THIS GUIDELINE WAS CREATED: An international panel of patients, clinicians, and methodologists produced these recommendations in adherence with standards for trustworthy guidelines using the GRADE approach. The recommendations are based on a linked systematic review and network meta-analysis. The panel considered an individual patient perspective and allowed contextual factors (such as resources) to be taken into account for countries and healthcare systems. THE EVIDENCE: The linked systematic review (published 31 Jul 2020) identified two randomised trials with 1300 participants, showing low certainty evidence that remdesivir may be effective in reducing time to clinical improvement and may decrease mortality in patients with severe covid-19. Remdesivir probably has no important effect on need for invasive mechanical ventilation. Remdesivir may have little or no effect on hospital length of stay. UNDERSTANDING THE RECOMMENDATION: Most patients with severe covid-19 would likely choose treatment with remdesivir given the potential reduction in time to clinical improvement. However, given the low certainty evidence for critical outcomes and the fact that different perspectives, values, and preferences may alter decisions regarding remdesivir, the panel issued a weak recommendation with strong support for continued recruitment in randomised trials.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.005
metaresearch head score (Gemma)0.827
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.822
Threshold uncertainty score0.552

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0050.827
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.283
GPT teacher head0.605
Teacher spread0.323 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations121
Published2020
Admission routes1
Has abstractyes

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