Challenges in applying the GRADE approach in public health guidelines and systematic reviews: a concept article from the GRADE Public Health Group.

Background and Objective This article explores the need for conceptual advances and practical guidance in the application of the GRADE approach within public health contexts. Methods We convened an expert workshop and conducted a scoping review to identify challenges experienced by GRADE users in pu...

Full description

Bibliographic Details
Authors: Hilton Boon, Michele, Thomson, Hilary, Shaw, Beth, Akl, Elie A., Lhachimi, Stefan K., López Alcalde, Jesús, Klugar, Miloslav, Choi, Leslie, Saz-Parkinson, Zuleika, Mustafa, Reem A., Langendam, Miranda W., Crane, Olivia, Morgan, Rebecca L., Rehfuess, Eva, Johnston, Bradley C., Chong, Lee Yee, Guyatt, Gordon H., Schunemann, Holger J., Vittal Katikireddi, Srinivasa
Format: article
Publication Date:2021
Country:España
Institution:Universidad Francisco de Vitoria
Repository:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
Language:English
OAI Identifier:oai:ddfv.ufv.es:10641/2782
Online Access:http://hdl.handle.net/10641/2782
Access Level:Open access
Description
Summary:Background and Objective This article explores the need for conceptual advances and practical guidance in the application of the GRADE approach within public health contexts. Methods We convened an expert workshop and conducted a scoping review to identify challenges experienced by GRADE users in public health contexts. We developed this concept article through thematic analysis and an iterative process of consultation and discussion conducted with members electronically and at three GRADE Working Group meetings. Results Five priority issues can pose challenges for public health guideline developers and systematic reviewers when applying GRADE: (1) incorporating the perspectives of diverse stakeholders; (2) selecting and prioritizing health and “nonhealth” outcomes; (3) interpreting outcomes and identifying a threshold for decision-making; (4) assessing certainty of evidence from diverse sources, including nonrandomized studies; and (5) addressing implications for decision makers, including concerns about conditional recommendations. We illustrate these challenges with examples from public health guidelines and systematic reviews, identifying gaps where conceptual advances may facilitate the consistent application or further development of the methodology and provide solutions. Conclusion The GRADE Public Health Group will respond to these challenges with solutions that are coherent with existing guidance and can be consistently implemented across public health decision-making contexts.

Similar Items