Disaster medicine and public health preparedness · 2025
Development of Evidence-based Guidelines on Assessment and Management of Internal Contamination with Transuranic Actinides.
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Li Chunsheng, Kenbayeva Zhanat, Dainiak Nicholas, Yepes-Nuñez Juan José, Zeeb Hajo, Gill Sehajpreet, Akashi Makoto, Alves Arlene, Chang Arthur, DiCarlo Andrea, Iddins Carol, Kazzi Ziad, Klumpp John, Osamu Kurihara, Lopez Maria Antonia, Phan Guillaume, Port Matthias, Riddell Anthony, Salame-Alfie Adela, Sawant Pramilla, Tatsuzaki Hideo, Vassilenko Valentina
Аннотация
OBJECTIVES: To describe the process of the development of evidence-based guidelines on the assessment and clinical management of internal contamination with transuranic actinides (specifically plutonium, americium, and curium) in incidents where workers, emergency responders, and the public might uptake these radionuclides internally through inhalation, ingestion, or wound contamination.
METHODS: The World Health Organization (WHO) set up a guidelines development group (GDG) that follows the protocol required for producing evidence-based recommendations as described elsewhere. The GRADE® approach was applied throughout the process, including developing research questions formulation, prioritization and rating the importance for the outcomes, assessing the certainty of the evidence, considering contextual factors, and making recommendations.
RESULTS: Through 3 working group meetings held 2023-2024, the GDG defined and rated patient-important health outcomes, and evidence gathered through systematic reviews and its certainty rating, working towards formulating the recommendations using an evidence-to-recommendation (EtR) framework.
CONCLUSIONS: The WHO protocol for developing health care management guidelines uses a transparent and robust evidence-based GRADE® approach. Once published, these guidelines will provide the first evidence-based recommendations for assessment and clinical management of internal contamination with transuranic actinides.
METHODS: The World Health Organization (WHO) set up a guidelines development group (GDG) that follows the protocol required for producing evidence-based recommendations as described elsewhere. The GRADE® approach was applied throughout the process, including developing research questions formulation, prioritization and rating the importance for the outcomes, assessing the certainty of the evidence, considering contextual factors, and making recommendations.
RESULTS: Through 3 working group meetings held 2023-2024, the GDG defined and rated patient-important health outcomes, and evidence gathered through systematic reviews and its certainty rating, working towards formulating the recommendations using an evidence-to-recommendation (EtR) framework.
CONCLUSIONS: The WHO protocol for developing health care management guidelines uses a transparent and robust evidence-based GRADE® approach. Once published, these guidelines will provide the first evidence-based recommendations for assessment and clinical management of internal contamination with transuranic actinides.