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Birgit Teufer1, Barbara Nußbaumer-Streit1, Lukas Schwingshackl2

  • 1Department für Evidenzbasierte Medizin und Evaluation, Donau-Universität Krems, Krems, Österreich.

Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen
|September 1, 2020
PubMed
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This summary is machine-generated.

This guidance helps incorporate health equity into the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence to decision process. It offers two methods to ensure recommendations benefit all populations, especially disadvantaged groups.

Area of Science:

  • Health Equity Research
  • Clinical Guideline Development
  • Evidence-Based Medicine

Background:

  • Health equity is crucial in clinical guideline development.
  • Existing frameworks may not adequately address equity considerations.
  • The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system is widely used for guideline development.

Purpose of the Study:

  • To provide detailed guidance on integrating health equity into the GRADE evidence to decision (EtD) process.
  • To offer practical approaches for guideline panels to consider equity.
  • To support the development of recommendations that promote health equity.

Main Methods:

  • Guidance developed using the GRADE evidence to decision framework.
  • Iterative review and modification of draft documents.
Keywords:
DisadvantagedEvidence to decision processGRADE LeitlinienGRADE guidelinesGerechtigkeit im GesundheitswesenHealth equitySpecial populationsUnderservedUnterversorgungsoziale Benachteiligungspezielle Zielgruppenvon der Evidenz zur Empfehlung

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  • In-person discussions among project group members and input from other GRADE members.

    • Main Results:

    • Two primary approaches for incorporating equity are proposed: assessing intervention impact on equity and integrating equity into EtD criteria judgments.
    • Guidance and illustrative examples are provided for applying these approaches.
    • Consideration of equity is essential for both general and population-specific guidelines.

    Conclusions:

    • Guideline panels must consider the impact of recommendations on health equity, particularly for remote, underserved, and disadvantaged populations.
    • Equity judgments can be incorporated across the entire GRADE EtD framework.
    • This paper is the final in a series by the GRADE equity subgroup on considering equity in guideline development.