GRADE Guidance: Update on Developing Good Practice Statements in Guidelines

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.