Evidence-to-Decision Frameworks: Enhancing the Quality and Rigour of Guidelines and Recommendations

The journey of guidelines being informed by evidence is less than 50 years old, but it has seen notable advances documented in various publication series and led by key organizations.Although Evidence-to-Decision (EtD) frameworks were officially born in 2016, since the early 2000s, groups like GRADE had begun to formulate key determinants of the recommendation-formulation process.The EtD frameworks started with criteria such as the balance between desirable and undesirable outcomes, values and preferences, and resource use. Nowadays, they are extended to cover criteria like planetary health, human rights, and socio-cultural acceptability.Experiences with the use of EtD frameworks are generally positive; they are flexible, facilitate multidisciplinary discussions, and bring rigor and transparency to the guidelines.More guidance is required on how to use EtD frameworks, as well as more research to understand how they can lead to better guidelines, and more recently, how artificial intelligence can responsibly help navigate this path.