Cochrane “evidence relevant to” rehabilitation of people with post COVID-19 condition. What it is and how it has been mapped... 2022 Negrini et al

Full title: Cochrane “evidence relevant to” rehabilitation of people with post COVID-19 condition. What it is and how it has been mapped to inform the development of the World Health Organization recommendations

Cochrane Rehabilitation developed a series of actions to provide the global rehabilitation community with the best available evidence to respond to the COVID-19 pandemic. These initiatives constituted the REH-COVER (Rehabilitation COVID-19 evidence-based response) action.

In March 2020, the first initiative started in agreement with the European Journal of Physical and Rehabilitation Medicine (EJPRM): the rapid systematic review of all papers relevant to COVID-19 rehabilitation to inform rehabilitation health professionals rapidly. Currently, we are facing the long-term consequences of COVID-19, initially called “long Covid” and now named post COVID-19 condition (PCC), which led to the request by the WHO Rehabilitation Programme for evidence synthesis to support the development of specific recommendations. Cochrane Rehabilitation provided the best available evidence from the REH-COVER rapid living systematic review results, a systematic scoping review on the models of care and a summary of “evidence relevant to” the rehabilitation for adults with PCC.

Based on this evidence, expert groups developed the 16 recommendations for the rehabilitation of adults with PCC recently published in Chapter 24 of the WHO “Clinical management of COVID-19 living guideline.” This paper aims to introduce the Special Section of EJPRM reporting the work performed by Cochrane Rehabilitation to produce a summary of the existing “evidence relevant to” the rehabilitation of adults with PCC. The paper reports the methodology (overview of systematic reviews with mapping) and introduces the concept of “evidence relevant to” rehabilitation.

Open access, https://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y9999N00A22120501

 

Not sure I understand the value of publishing a paper out of the section that most people will skip.

Anyway this is about this aspirational document that consists mostly of "if we figure out how to rehabilitate those patients, we could rehabilitate them but let's rehabilitate them anyway, I guess?". This paper even finishes saying this is provisional and they are waiting for actual evidence, so I'm not sure what the point of any of this is besides publishing for the sake of publishing something since they're talking about evidence for something they don't have any, and cannot even see the significant role they played in this.

I would really like for Cochrane to go away forever. That would be very good for the world.

 

Oh dear looks like WHO may have legitimised this ---- let's face it, experience has shown that these "systematic scoping review" are just unreliable data dressed up as something other than dodgy data.

Depressing and that's before I've tried to look for the studies they "reviewed" or rather used for "evidence synthesis to support the development of specific recommendations".

This is so cliché ridden that it should jump out as garbage --- shouldn't it?

 

The WHO guideline actually shows a good understanding of PEM. They devote an entire page to it and explicitly recommend against GET (pg. 110):

 

Thanks for pointing that out - reassuring.

 

Uh. I thought it was weird that in the "Effect of using a structured pacing protocol on PESE" paper included this "pacing protocol" from the WHO:



But upon searching for it, there is a thing called BORG CR-10 from the WHO, but it's not a protocol for anything, it's a generic scale of exertion. There is no such thing as a "WHO BORG CR-10 pacing protocol", it has nothing to do with pacing, it's not even a protocol. So it looks like in that paper, they just mixed the two and called it a pacing protocol from the WHO.

I guess that's one way of going around guidelines explicitly stating something is not recommended. There's probably something I'm missing here but things are always weird in EBM.