There are few people better placed than Sharon McGowan, Chair of ALEC’s Strategic Advisory Committee, to reflect on the rapid evolution of living evidence in Australia, and beyond. As a founding member of the original Australian Living Evidence Consortium, first Chair of the National Clinical Evidence Taskforce (NCET) and former CEO of Stroke Australia, Sharon has played a key role in the development of the world’s first living stroke guidelines and Australia’s national Covid living guidelines.
‘From our very beginnings in 2017, ALEC has been a genuinely cross-disciplinary, multi-organisation group with a singular goal’, Sharon says. ‘That goal was – and still is – to work together to gather and analyse the latest in global research, and get it directly to clinicians in near real-time. So our move from a consortium to a collaboration more accurately conveys the culture of this extraordinary initiative which is transforming the way we think about evidence, generate actionable guidance and build a single source of truth for clinicians and consumers.
‘This approach is an inspiring example of effective collaboration involving clinicians, consumers, researchers, methodologists and member organisations across cancer, diabetes, heart disease, infectious diseases, kidney disease, musculoskeletal conditions, stroke, pregnancy and postnatal care. Together, we’ve developed and delivered a globally-recognised living evidence approach that benefits all Australians. It combines rigorous, evidence-based methods, rapid updating and the latest technology – including machine learning and automation. We can now make, modify and update clinical recommendations rapidly in response to the publication of new research evidence. In today’s rapidly shifting health landscape, this is vital. It also represents an especially great leap forward when you consider that in many fields, traditional clinical guidelines are only produced every 5 to 7 years.’
One of the great examples of ALEC’s pioneering work in living evidence and collaboration is the work of the National Clinical Evidence Taskforce (NCET). Rapidly convened by ALEC in March 2020, the Taskforce brought together 200+ contributors from 35 national peak health bodies representing all major clinical groups. It quickly demonstrated that partnerships are a foundational element of living evidence production, drawing on professional, research and consumer groups and global organisations including WHO, NICE, Cochrane Canada and the Danish Health Authority.
‘At a global level, the response to the COVID-19 pandemic super charged a sense of urgency that helped us break down traditional barriers to innovation and cross-disciplinary collaboration,’ says Professor Steve McGloughlin, Clinical Director of ALEC and Director of the ICU at Melbourne’s Alfred Hospital. ‘At the national level, ALEC and NCET played a critical role in harnessing this collective good will and expertise. We brought together the essential infrastructure, networks and know-how to deliver living clinical guidelines.’
‘The results speak for themselves. Clinicians – who were often working in crisis conditions – could access near-real time, trusted, evidence-based recommendations and resources that were updated each and every week. This is just one of many real world examples of living evidence in action and the ways it’s opening up new possibilities in evidence-based care.’
Three years on, NCET’s 15 expert panels have updated the national COVID-19 clinical guidelines over 100 times with more than 200 recommendations and 1.5+ million website views. Clinical scope expanded over time to include guidance for the care of children, adolescents, adults, pregnant or breastfeeding women, and older people – highlighting the widespread impact and value of living evidence for all.
‘There’s no doubt that the pandemic proved a testing ground for living evidence in Australia and around the globe,’ says Professor Tari Turner, ALEC Academic Director. ‘We’re now embracing the opportunity to take the experiences and expertise gained throughout that tumultuous time, along with the development of world-first ALEC guidelines in stroke, diabetes, kidney disease and arthritis to underpin and inspire our next chapter.’
‘While funding for NCET ended in July this year, ALEC continues to draw on proven NCET living guidelines model for our latest major project – the five year, Commonwealth Government funded Living Evidence for Australian Pregnancy and Postnatal Care (LEAPP) guidelines. We’ll also continue our work in chronic diseases, and expand to cover the increasingly critical areas of climate health and infectious diseases.’
‘So while our name has changed a little – our original ALEC acronym and our commitment to producing trusted, real time evidence for all Australians lives on. The collaboration is committed to realising a future where living evidence is the norm, a single source of trustworthy truth for clinicians and consumers across Australia.’