Guideline organizations' guidance documents paper 8: considering equity

To ensure practice guidelines contribute to improving equity, guideline developers need to consciously consider populations experiencing inequities throughout the process. Our aim was to describe whether and how guideline-producing organizations consider equity in the guideline development process as described in their guidance documents on guideline development.

We conducted a descriptive summary of guideline-producing organizations using different sources and retrieved their publicly available guidance documents on guideline development (eg, handbooks). We screened guidance documents and abstracted information about equity consideration within topics of the GIN-McMaster guideline development checklist.

Of 133 identified guideline-producing organizations with guidance documents on guideline development, 52% considered equity in their guidance documents in at least one of the 18 topics of the GIN-McMaster checklist. Most organizations were professional (55%) and national (77%). The median number of topics considered per organization was 2 (IQR = 1-4), with the World Health Organization (WHO) considering the highest number of topics. The topic in which equity was considered the most was "guideline group membership" (57%), while the topic in which equity was considered the least was "conflict of interest considerations" (1%). In addition, some of the terms related to equity and populations experiencing inequities used were "inequitable or equality" and "minority or disadvantaged", respectively.

More than half of guideline-producing organizations consider equity in guideline development, with considerations limited to a few groups of populations and a few topics of the guideline development process.