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The American Academy of Pediatrics developed a tool to assess clinical guidelines for bias, aiming to reduce health inequities. This evidence-informed instrument helps identify and revise guidelines that may perpetuate harm to marginalized groups.

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Area of Science:

  • Health Services Research
  • Health Equity
  • Clinical Practice Guidelines

Background:

  • Clinical guidelines and policies can perpetuate healthcare inequities and health disparities.
  • Bias, discrimination, and racist ideologies embedded in guidance can harm marginalized communities and the broader population.
  • The American Academy of Pediatrics (AAP) develops clinical practice guidelines (CPGs) and clinical reports (CRs) for child health.

Purpose of the Study:

  • To develop and pilot an evidence-informed instrument to assess the inappropriate use of race and/or ethnicity in AAP CPGs and CRs.
  • To ensure AAP CPGs and CRs promote health equity.
  • To provide a model for other professional societies and healthcare organizations.

Main Methods:

  • Convened health services researchers to develop an assessment instrument.
  • Applied the instrument to the compendium of active AAP CPGs and CRs.
  • Developed an approach for prioritizing guidelines needing revision and achieving buy-in.

Main Results:

  • An evidence-informed instrument was developed and piloted.
  • A methodology for assessing CPGs/CRs for inappropriate use of race/ethnicity was established.
  • A process for guideline revision prioritization and stakeholder buy-in was outlined.

Conclusions:

  • The developed instrument and process can help identify and mitigate bias in clinical guidelines.
  • This approach supports the AAP's commitment to health equity in child health.
  • The methodology is adaptable for use by other professional organizations to evaluate their guidelines.