Per Vandvik

I'm Peter van Wyk.

I'm a general internist based in Oslo, Norway.

I'm working in a hospital, but I spend most of my time on creating guidelines, clinical practice guidelines.

And I also work in a nonprofit foundation called Magic, where we try to produce better trustworthy decision support tools for clinicians and patients.

But I can see the COVID-19 pandemic as a great example where we need global coordination of guidance.

I think some organizations, such as WHO, is in the right position to produce trustworthy guidance, and then that guidance could be reused, adapted,

and contextualized for different countries and healthcare systems.

I think WHO wants to take that role, but the big question is how could WHO work with partners to achieve harmonized updating of the guidance and then make the evidence and guidance available for others to reuse.

So I think what we will see happening over the months to come is a number of trials will be published

We will have higher certainty evidence about what works and what does not work.

And then in that situation, we will need what we call living evidence or living guidance.

And I think the ability to rapidly update the evidence and the guidance is crucial.

And again, I think that's where we need to have a global collaboration to make that happen efficiently because there's huge duplication of efforts now.

Also, I think the barriers are huge.

across political and other factors.

So we know from our work, for instance, in our BMJ RAP recommendations that we do, just being a collaborative network of people, clinicians, patients, methodologists across the world, we could actually quite rapidly produce and update guidance.

But when we work with organizations, we see that they all are

struggling with changing the way they work, and not to mention how to collaborate across organizations and countries.

Because then they would actually have to explicitly agree on the standards for how to produce guidance, the methods, the processes.

And so far, I think that is a major barrier, which COVID-19 just highlights the need to innovate the way organizations collaborate.