Proof of concept: all-virtual guideline development workshops using GRADE during the COVID-19 pandemic

The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework is an approach to assessing the certainty of evidence and developing clinical practice recommendations based on a systematic review of the relevant literature.1 Since 2014, the US GRADE Network (USGN) has held a total of 16 semiannual guideline development workshops for attendees ranging from healthcare organisation staff to patients to guideline panel members. Using an in-person format in different cities of the continental USA, experienced educators with extensive methodological background have taught participants how to apply the GRADE approach. In October 2020, the COVID-19 pandemic forced us to shift to a virtual format. Since that time, we have held a total of three online workshops, which provided us with the unique opportunity to compare the experiences of in-person and virtual participants. As part of a routine quality improvement effort and based on our retrospective analysis of post-workshop feedback surveys, we compared attendees' self-perceived understanding of GRADE, determined how the virtual format affected those participants' ability to attend, and assessed whether their perceived level of engagement and interaction was similar when compared with that of in-person participants. We present our experience in accordance with the Guideline for Reporting Evidence-based practice Educational interventions and Teaching2.