Evidence to decision frameworks enabled structured and explicit development of healthcare recommendations

Objective: The aim of this study is to identify and describe the processes suggested for the formulation of healthcare recommendations in healthcare guidelines available in guidance documents. Methods: We searched international databases in May 2020 to retrieve guidance documents published by organi...

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Detalles Bibliográficos
Autores: Meneses-Echavez, Jose F.|||0000-0003-4312-6909, Bidonde, Julia, Yepes-Nuñez, Juan José, Poklepović Peričić, Tina, Puljak, Livia, Bala, Malgorzata M.|||0000-0003-1978-7264, Storman, Dawid|||0000-0001-6643-1389, Swierz, Mateusz J., Zajac, Joanna|||0000-0001-7503-5847, Montesinos-Guevara, Camila|||0000-0001-6763-3644, Zhang, Yuan, Chavez Guapo, Nathaly, Schünemann, Holger|||0000-0003-3211-8479, Flottorp, Signe|||0000-0003-2961-7461, Alonso-Coello, Pablo|||0000-0002-8001-8504
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:284176
Acceso en línea:https://ddd.uab.cat/record/284176
https://dx.doi.org/urn:doi:10.1016/j.jclinepi.2022.06.004
Access Level:acceso abierto
Palabra clave:Practice guidelines
Decision making
Evidence-based practice
Methods
Evidence-to-decision framework
Clinical practice guidelines
GRADE
Health recommendations
Certainty of evidence
Systematic reviews
Evidence synthesis
Descripción
Sumario:Objective: The aim of this study is to identify and describe the processes suggested for the formulation of healthcare recommendations in healthcare guidelines available in guidance documents. Methods: We searched international databases in May 2020 to retrieve guidance documents published by organizations dedicated to guideline development. Pairs of researchers independently selected and extracted data about the characteristics of the guidance document, including explicit or implicit recommendation-related criteria and processes considered, as well as the use of evidence to decision (EtD) frameworks. Results: We included 68 guidance documents. Most organizations reported a system for grading the strength of recommendations (88%), half of them being the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Two out of three guidance documents (66%) proposed the use of a framework to guide the EtD process. The GRADE-EtD framework was the most often reported framework (19 organizations, 42%), whereas 20 organizations (44%) proposed their own multicriteria frameworks. Using any EtD framework was related with a more comprehensive set of recommendation-related criteria compared to no framework, especially for criteria like values, equity, and acceptability. Conclusion: Although limited, the use of EtD frameworks was associated with the inclusion of relevant recommendation criteria. Among the EtD structured frameworks, the GRADE-EtD framework offers the most comprehensive perspective for evidence-informed decision-making processes.