Challenges in applying the GRADE approach in public health guidelines and systematic reviews : a concept article from the GRADE Public Health Group
Hilton Boon, Michele (MRC/CSO Social and Public Health Sciences Unit, University of Glasgow)
Thomson, Hilary (MRC/CSO Social and Public Health Sciences Unit, University of Glasgow)
Shaw, Beth (Center for Evidence-based Policy, Oregon Health & Science University)
Akl, Elie A. (Department of Internal Medicine, American University of Beirut)
Lhachimi, Stefan K. (Health Sciences Bremen, University of Bremen)
Lopez-Alcalde, Jesus (Universitat Autònoma de Barcelona. Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva)
Klugar, Miloslav (Faculty of Medicine, Czech National Centre for Evidence-Based Healthcare and Knowledge Translation)
Choi, Leslie (The Department of Vector Biology, Partnership for Increasing the Impact of Vector Control, Liverpool School of Tropical Medicine)
Saz-Parkinson, Zuleika (European Commission, Joint Research Centre, Ispra, Italy)
Mustafa, Reem A. (Departments of Medicine and Biomedical & Health Informatics, University of Missouri-Kansas City)
Langendam, Miranda W. (Amsterdam Universitair Medische Centra (Amsterdam, Països Baixos))
Crane, Olivia (National Institute for Health and Care Excellence (NICE))
Morgan, Rebecca L. (Department of Health Research Methods, Evidence, and Impact, McMaster University)
Rehfuess, Eva (Institute for Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich)
Johnston, Bradley C. (Department of Nutrition, Texas A&M University)
Chong, Lee Yee (Cochrane Public Health and Health Systems Network, University of Oxford)
Guyatt, Gordon H. (Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada)
Schünemann, Holger (Michael G DeGroote Cochrane Canada)
Katikireddi, Srinivasa Vittal (MRC/CSO Social and Public Health Sciences Unit, University of Glasgow)

Data:	2021
Resum:	This article explores the need for conceptual advances and practical guidance in the application of the GRADE approach within public health contexts. 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. 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. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	GRADE ; Public health ; Guidelines ; Nonrandomized studies ; Health policy ; Social determinants
Publicat a:	Journal of clinical epidemiology, Vol. 135 (july 2021) , p. 42-53, ISSN 1878-5921

DOI: 10.1016/j.jclinepi.2021.01.001
PMID: 33476768

12 p, 455.3 KB

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