GRADE equity guidelines 3: considering health equity in GRADE guideline development: rating the certainty of synthesized evidence
نویسندگان
چکیده
OBJECTIVES The aim of this paper is to describe a conceptual framework for how to consider health equity in the Grading Recommendations Assessment and Development Evidence (GRADE) guideline development process. STUDY DESIGN AND SETTING Consensus-based guidance developed by the GRADE working group members and other methodologists. RESULTS We developed consensus-based guidance to help address health equity when rating the certainty of synthesized evidence (i.e., quality of evidence). When health inequity is determined to be a concern by stakeholders, we propose five methods for explicitly assessing health equity: (1) include health equity as an outcome; (2) consider patient-important outcomes relevant to health equity; (3) assess differences in the relative effect size of the treatment; (4) assess differences in baseline risk and the differing impacts on absolute effects; and (5) assess indirectness of evidence to disadvantaged populations and/or settings. CONCLUSION The most important priority for research on health inequity and guidelines is to identify and document examples where health equity has been considered explicitly in guidelines. Although there is a weak scientific evidence base for assessing health equity, this should not discourage the explicit consideration of how guidelines and recommendations affect the most vulnerable members of society.
منابع مشابه
GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale
OBJECTIVES This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for development of clinical, public health, and health system guidelines. STUDY DESIGN AND SETTING We searched for guideline methodology articles, conceptual articles about health equity, and examples...
متن کاملThe GRADE Working Group clarifies the construct of certainty of evidence.
OBJECTIVE To clarify the grading of recommendations assessment, development and evaluation (GRADE) definition of certainty of evidence and suggest possible approaches to rating certainty of the evidence for systematic reviews, health technology assessments, and guidelines. STUDY DESIGN AND SETTING This work was carried out by a project group within the GRADE Working Group, through brainstormi...
متن کاملIncorporating equity issues into the development of Colombian clinical practice guidelines: suggestions for the GRADE approach Incorporando equidad al desarrollo de guías de práctica clínica colombianas: sugerencias para la aproximación Grade
Objective To propose how to incorporate equity issues, using the GRADE approach, into the development and implementation of Colombian Clinical Practice Guidelines. Methodology review and the development of a preliminary proposal about how to include equity Results A proposal on how to incorporate equity issues into the GRADE approach was developed. It places particular emphasis on the recogniti...
متن کاملProtocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials
BACKGROUND Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for a...
متن کاملHow equity is addressed in clinical practice guidelines: a content analysis
OBJECTIVES Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs). SETTING Content analysis of methodological publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Methodological publications were included if they provided checklists/frameworks on when, ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 90 شماره
صفحات -
تاریخ انتشار 2017