Evidence to decision frameworks enabled structured and explicit development of healthcare recommendations
Por:
Meneses-Echavez, JF, Bidonde, J, Yepes-Nunez, JJ, Pericic, TP, Puljak, L, Bala, MM, Storman, D, Swierz, MJ, Zajac, J, Montesinos-Guevara, C, Zhang, Y, Guapo, NC, Schunemann, H, Flottorp, S, Alonso-Coello, P
Publicada:
1 oct 2022
Ahead of Print:
1 jul 2022
Resumen:
Objective: The aim of this study is to identify and describe the processes suggested for the formulation of healthcare recommendations in healthcare guidelines available in guidance documents.
Methods: We searched international databases in May 2020 to retrieve guidance documents published by organizations dedicated to guideline development. Pairs of researchers independently selected and extracted data about the characteristics of the guidance document, including explicit or implicit recommendation-related criteria and processes considered, as well as the use of evidence to decision (EtD) frameworks.
Results: We included 68 guidance documents. Most organizations reported a system for grading the strength of recommendations (88%), half of them being the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Two out of three guidance documents (66%) proposed the use of a framework to guide the EtD process. The GRADE-EtD framework was the most often reported framework (19 organizations, 42%), whereas 20 organizations (44%) proposed their own multicriteria frameworks. Using any EtD framework was related with a more comprehensive set of recommendation-related criteria compared to no framework, especially for criteria like values, equity, and acceptability.
Conclusion: Although limited, the use of EtD frameworks was associated with the inclusion of relevant recommendation criteria. Among the EtD structured frameworks, the GRADE-EtD framework offers the most comprehensive perspective for evidence-informed decision-making processes. (C) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Filiaciones:
Meneses-Echavez, JF:
Norwegian Inst Publ Hlth, Oslo, Norway
Univ Santo Tomas, Fac Cultura Fis Deporte & Recreac, Bogota, Colombia
Bidonde, J:
Norwegian Inst Publ Hlth, Oslo, Norway
Univ Saskatchewan, Coll Med, Sch Rehabil Sci, Saskatoon, SK, Canada
Yepes-Nunez, JJ:
Univ Los Andes, Sch Med, Bogota, Colombia
Fdn Santa Fe Bogota Univ Hosp, Internal Med Sect, Pulmonol Serv, Bogota, Colombia
Pericic, TP:
Univ Split, Sch Med, Dept Res Biomed & Hlth, Split, Croatia
Puljak, L:
Catholic Univ Croatia, Ctr Evidence Based Med & Hlth Care, Zagreb, Croatia
Bala, MM:
Jagiellonian Univ Med Coll, Systemat Reviews Unit, Dept Hyg & Dietet, Chair Epidemiol & Prevent Med, Krakow, Poland
Storman, D:
Jagiellonian Univ Med Coll, Chair Epidemiol & Prevent Med, Systemat Reviews Unit, Dept Hyg & Dietet,Dept Adult Psychiat,Univ Hosp, Krakow, Poland
Swierz, MJ:
Jagiellonian Univ Med Coll, Systemat Reviews Unit, Dept Hyg & Dietet, Chair Epidemiol & Prevent Med, Krakow, Poland
Zajac, J:
Jagiellonian Univ Med Coll, Systemat Reviews Unit, Dept Hyg & Dietet, Chair Epidemiol & Prevent Med, Krakow, Poland
Montesinos-Guevara, C:
Univ UTE, Fac Ciencias Salud Eugenio Espejo, Ctr Invest Salud Publ & Epidemiol Clin CISPEC, Quito, Ecuador
Zhang, Y:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Guapo, NC:
Univ Sabana, Programa Fisioterapia, Fac Enfermeria & Rehabil, Chia, Colombia
Schunemann, H:
McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada
Flottorp, S:
Univ Oslo, Inst Hlth & Soc, Oslo, Norway
Alonso-Coello, P:
Biomed Res Inst St Pau IIB St Pau CIBERESP, Iberoamer Cochrane Ctr, Barcelona, Spain
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