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GRADE Guidance: Update on Developing Good Practice Statements in Guidelines.

Omar Dewidar1, Elie A Akl2, Gian Paolo Morgano3

  • 1Temerty Faculty of Medicine, University of Toronto, Toronto, and Bruyère Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada (O.D.).

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|January 19, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

This updated guidance from the GRADE Working Group clarifies the development of good practice statements (GPSs). It offers practical steps and a new classification system to improve guideline trustworthiness and reduce overuse.

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Area of Science:

  • Health Sciences
  • Clinical Guidelines
  • Evidence-Based Practice

Background:

  • Published guidance on developing good practice statements (GPSs) by the GRADE Working Group exists, but their appropriate development remains challenging.
  • Existing methods require nuanced operationalization for effective implementation in guideline development.

Purpose of the Study:

  • To provide updated, operationally nuanced guidance for the development of good practice statements (GPSs).
  • To enhance the trustworthiness of clinical guidelines and reduce the inappropriate use or overuse of GPSs.

Main Methods:

  • Leveraged the original 5 signaling questions from the GRADE guidance.
  • Incorporated feedback from multiple GRADE Working Group meetings, including iterative discussions and presentations for approval.
  • Classified GPSs into three categories: ethics/human rights, essential principles/practices/protocols, and established scientific evidence.

    • Main Results:

    • Updated definition and classification of GPSs into three distinct categories.
    • Recommended selection of relevant Evidence to Decision criteria to assess downstream consequences of implementing statements.
    • Introduced a tool to streamline GPS development and reporting processes.

    Conclusions:

    • Adherence to the updated GRADE guidance will improve the development and trustworthiness of clinical guidelines.
    • The revised approach and tools aim to facilitate appropriate use and reduce overuse of good practice statements.