GRADE guidance 40: The GRADE evidence-to-decision framework for environmental and occupational health
Por:
Senerth, E, Whaley, P, Akl, E, Beverly, B, Alonso-Coello, P, Rooney, A, Schünemann, HJ, Thayer, KA, Tsaioun, K, Morgan, RL
Publicada:
1 mar 2025
Ahead of Print:
1 mar 2025
Resumen:
Objective: To provide guidance for the use of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision (EtD) framework for environmental and occupational health (EOH). Study design and setting: We conducted a systematic review and narrative synthesis of published and public EOH decision frameworks, followed by a modified Delphi process leading to development of a draft GRADE EtD framework for EOH. We pilot tested the provisional framework through a virtual workshop series, which further informed guidance for the framework's application. We presented a summary of the results to all attendees of the GRADE Working Group meeting for feedback in July 2022 and November 2022, and for approval in May 2023. Results: Consistent with existing GRADE EtD frameworks, the EtD framework for EOH includes a scoping and contextualization process and twelve assessment criteria. Modifications to the existing EtD frameworks include: consideration of the socio-political context when making judgments about the priority of the problem and feasibility of different alternatives; the addition of timing when making judgments about benefits and harms, the balance of effects, and feasibility; broadening of the equity criterion to include considerations beyond health equity; and more explicit accommodation of variable or conflicting stakeholder views when considering values and acceptability. The new EtD framework is also accompanied by a user guide intended to support its implementation in the EOH context. Conclusion: Policymakers, regulators, and other stakeholders may use this GRADE EtD framework to approach decision-making about environmental and occupational exposures and interventions.
Filiaciones:
Senerth, E:
George Washington Univ, Milken Inst Sch Publ Hlth, Dept Epidemiol, 950 New Hampshire Ave NW 2, Washington, DC 20052 USA
Johns Hopkins Bloomberg Sch Publ Hlth, Evidence Based Toxicol Collaborat, 615 North Wolfe St,Rm W7032, Baltimore, MD 21205 USA
Whaley, P:
Johns Hopkins Bloomberg Sch Publ Hlth, Evidence Based Toxicol Collaborat, 615 North Wolfe St,Rm W7032, Baltimore, MD 21205 USA
Univ Lancaster, Lancaster Environm Ctr, Lancaster LA1 4YQ, England
Akl, E:
Amer Univ Beirut, POB 11-0236, Beirut, Lebanon
Beverly, B:
NIEHS, Div Natl Toxicol Program, NIH, Dept Hlth & Human Serv, POB 12233,Mail Drop K2-02, Res Triangle Pk, NC 27709 USA
Alonso-Coello, P:
Hosp Santa Creu & Sant Pau, Biomed Res Inst St Pau IIB St Pau, Iberoamerican Cochrane Ctr, Barcelona, Spain
Cardiovasc Res Ctr CSIC, Sant Antoni Maria Claret 167, Barcelona 08025, Spain
Drone Hopper Co, Madrid, Spain
Rooney, A:
NIEHS, Div Natl Toxicol Program, NIH, Dept Hlth & Human Serv, POB 12233,Mail Drop K2-02, Res Triangle Pk, NC 27709 USA
Schünemann, HJ:
Humanitas Univ, Dept Biomed Sci, Via R Levi Montalcini 4, I-20090 Pieve Emanuele, MI, Italy
Thayer, KA:
US Environm Protect Agcy, Ctr Publ Hlth & Environm Assessment, Chem & Pollutant Assessment Div, Off Res & Dev, Bldg B Room 211i, Res Triangle Pk, NC USA
Tsaioun, K:
Johns Hopkins Bloomberg Sch Publ Hlth, Evidence Based Toxicol Collaborat, 615 North Wolfe St,Rm W7032, Baltimore, MD 21205 USA
Morgan, RL:
McMaster Univ, Cochrane Canada & McMaster GRADE Ctr, Hlth Sci Ctr, Room 2C14,1280 Main St West, Hamilton, ON L8S 4K1, Canada
McMaster Univ, Hlth Sci Ctr, Dept Hlth Res Methods Evidence & Impact, Room 2C14,1280 Main St West, Hamilton, ON L8S 4K1, Canada
Case Western Reserve Univ Sch Med, 10900 Euclid Ave, Cleveland, OH 44106 USA
Green Submitted, gold
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