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Updated: Aug 2, 2025

Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
Published on: June 13, 2025
The BIGG-REC database makes available all WHO/PAHO evidence informed recommendations
Martín Ragusa1, Fernando Tortosa1, Gabriel Rada2
1Knowledge Translation and Evidence Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization (PAHO), Washington, DC, USA.
Objectives:
To build and maintain a living database of the Pan American Health Organization/World Health Organization (PAHO/WHO) recommendations developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
Study Design And Setting:
Guidelines are identified from WHO and PAHO databases. We periodically extract recommendations, according to the health and well-being targets of sustainable development goal 3 (SDG-3).
Results:
As of March 2022, the International database of GRADE guidelines (https://bigg-rec.bvsalud.org/en) database hosted 2,682 recommendations contained in 285 WHO/PAHO guidelines. Recommendations were classified as follows: communicable diseases (1,581), children's health (1,182), universal health (1,171), sexual and reproductive health (910), noncommunicable diseases (677), maternal health (654), COVID-19 (224), use of psychoactive substances (99), tobacco (14) and road and traffic accidents (16). International database of GRADE guidelines allows searching by SDG-3, condition or disease, type of intervention, institution, year of publication, and age.
Conclusion:
Recommendation maps provide an important resource for health professionals, organizations and member states that use evidence-informed guidance to make better decisions, providing a source for the adoption or adaptation of recommendations to meet their needs. This one-stop shop database of evidence-informed recommendations built with intuitive functionalities undoubtedly represents a long-needed tool for decision-makers, guideline developers, and the public at large.
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