A Critical Review of the Scientific Evidence and Recommendations in COVID-19 Management Guidelines

Background Little is known about the quality and potential impacts of the guidelines for COVID-19 management. Methods We systematically searched PubMed, Web of Science, Cochrane Library, guideline databases and specialty society Web sites to evaluate the quality of the retrieved guidelines using the Appraisal of Guidelines for Research and Evaluation II. Results A total of 66 guidelines were identified. Only 24% were categorized as “recommended” for clinical practice. The 211 identified recommendations for COVID-19 management were classified into four topics: respiratory support(27), ARDS management(31), anti-viral or immunomodulatory therapy(95), or other medicines(58). Only 63% and 56% recommendations were supported by, respectively, assessment of the strength of recommendation or level of evidence. There were notable discrepancies between the different guidelines regarding the recommendations on COVID-19 management. Conclusions The quality of the guidelines for COVID-19 management is heterogeneous, and the recommendations are rarely supported by evidence.

Hot Topics in Safety for Pediatric Anesthesia

Anesthesiology is one of the leading medical specialties in patient safety. Pediatric anesthesiology is inherently higher risk than adult anesthesia due to differences in the physiology in children. In this review, we aimed to describe the highest yield safety topics for pediatric anesthesia and efforts to ameliorate risk. Conclusions: Pediatric anesthesiology has made great strides in patient perioperative safety with initiatives including the creation of a specialty society, quality and safety committees, large multi-institutional research efforts, and quality improvement initiatives. Common pediatric peri-operative events are now monitored with multi-institution and organization collaborative efforts, such as Wake Up Safe.

Seventy Years and Counting: The Canadian Association of Radiologists’ Journal

Canadian radiology has its roots embedded in Montréal and this is no less true of the Canadian Association of Radiologists Journal, now celebrating its 70th Anniversary with the appointment of a new editor. A journal, Les Rayons-X—a monthly illustrated review published in Montréal and edited by Dr Henri Lasnier– preceded it by 40 years. Les Rayons-X was to last only 7 issues. However, Dr Lasnier clearly recognized the importance of a journal to what was then an emerging specialty. By 1950, the Canadian Association of Radiologists became the first specialty society in Canada to publish a scientific journal. We reflect on some facets of the evolution of the journal from a cottage industry to its adoption by a major publishing house and through the hands of 14 editors. In that time, radiology itself has undergone remarkable changes in its technological infrastructure leading to profound changes in the capacity of radiological practitioners and scientists to diagnose and treat disease. These changes themselves impose some constraints on a general radiology journal. The Association has at times faced substantial challenges that led to questions about its ability to sustain a journal in the face of competing priorities. Those challenges will likely recur in the future, not least in the face of other better-resourced journals. As the Canadian Association of Radiologists has evolved into a distinctive voice in Canadian medicine, we argue that a strong case can be made for preserving a platform for Canadian radiology featuring Canadian observations and perspectives, both scientific and “political.”