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Advancing evidence-based health care guidelines
Author: FMHS Marketing & Communications
Published: 16/01/2024

Dr Michael McCaul, a Senior Lecturer in the Division of Epidemiology and Biostatistics, is playing an instrumental role in informing evidence-based health care guidelines, not only on a national level, but on a global scale.

As a clinical epidemiologist and guideline methodologist specializing in evidence synthesis, McCaul's was appointed to the National Essential Medicines List Committee (NEMLC) during the Covid-19 pandemic. NEMLC is appointed by the Minister of Health with the objective of selecting medicines to be used in the public sector, based on a structured, unbiased and robust decision-making framework. NEMLC develops and reviews an essential medicines list for use in the public sector, accompanied, where possible, by standard treatment guidelines.

During the pandemic, the committee reviewed evidence for 33 molecules for potential treatment or prevention of Covid-19 and completed 69 rapid reviews.

McCaul led rapid reviews for Covid-19 and Adult Primary Health Care and provided methods guidance. His work with NEMLC has continued beyond the pandemic and he still regularly produces evidence synthesis summaries and systematic reviews informing national standard treatment guidelines and the National Essential Medicines List in South Africa.

“I have specifically been appointed as part of the Primary Healthcare and Adult Hospital Level Expert Review Committee, and together with Dr Clint Hendricks from the University of Cape Town, recently updated and published the Emergencies and Injuries Standard Treatment Guidelines (STG) Chapter," says McCaul. All the STGs and rapid reviews for the National Department of Health are available here:

McCaul, who is a founding member of the South Africa GRADE Network, have also provided evidence-based medicine and GRADE methods training and workshops to NEMLC and Primary Health Care and Essential Drugs List committees. The SA GRADE Network aims to advance the use of GRADE for evidence-informed decision making for policy and practice in the country. GRADE, which stands for 'Grading of Recommendations in Assessment, Development and Evaluation', is a practical approach to grading the quality of evidence and strength of recommendations. The SA GRADE Network is jointly managed by the Stellenbosch University's Centre for Evidence-based Health Care, and Cochrane South Africa, based in the South African Medical Research Council.

McCaul has a clinical background in emergency care and a special interest in research methods, evidence synthesis, biostatistics, and guideline development. “A key focus of my career is conducting applied research with real-world impact for policy and practice," says McCaul. “I have focused my efforts contributing to and building guideline development literacy and methods in low and middle-income countries, specifically in sub-Saharan Africa." He has been involved in a number of guideline development initiatives with varying roles, from an expert panellist in advanced first aid guidelines, to guideline methodologist for national emergency care guidelines, to GRADE and guideline methods co-chair for the World Health Organization.

In academia he also consults as a biostatistician to undergraduate and postgraduate students, supervises master's and doctoral students, and conducts high-impact systematic reviews, methods research and primary epidemiological research.

Caption: Dr Michael McCaul

Photo credit: Damien Schumann