GRADE equity guidelines 3 : considering health equity in GRADE guideline development: rating the certainty of synthesized evidence
Welch, Vivian A. (University of Ottawa and Bruyère Continuing Care)
Akl, Elie A. (McMaster University (Canadà))
Pottie, Kevin (University of Ottawa)
Ansari, Mohammed T. (University of Ottawa)
Briel, Matthias (McMaster University Health Sciences Centre)
Christensen, Robin (Bispebjerg and Frederiksberg Hospitals (Copenhagen, Dinamarca))
Dans, Antonio (University of the Philippines-Manila)
Dans, Leonila (University of the Philippines-Manila)
Eslava-Schmalbach, J (Universidad Nacional de Colombia)
Guyatt, Gordon (McMaster University (Canadà))
Hultcrantz, Monica (Karolinska Institutet (Estocolm, Suècia))
Jull, Janet (University of Ottawa)
Katikireddi, Srinivasa Vittal (University of Glasgow)
Lang, Eddy (University of Calgary)
Matovinovic, Elizabeth (Chiang Mai University)
Meerpohl, Joerg J. (Université Paris Descartes)
Morton, Rachael L. (The University of Sydney)
Mosdol, Annhild (Norwegian Institute of Public Health)
Murad, M.Hassan (Mayo Clinic)
Petkovic, Jennifer (Bruyère Research Institute & University of Ottawa)
Schünemann, Holger (McMaster University (Canadà))
Sharaf, Ravi (Long Island Jewish Medical Center)
Shea, Bev (University of Ottawa)
Singh, Jasvinder A. (Mayo Clinic College of Medicine)
Solà, Ivan (Institut d'Investigació Biomèdica Sant Pau)
Stanev, Roger (University of Washington)
Stein, Airton (Universidade Federal de Ciencias da Saude de Porto Alegre (Ufcspa))
Thabaneii, Lehana (McMaster University (Canadà))
Tonia, Thomy (University of Bern)
Tristan, Mario (Cochrane Central America & Caribbean Spanish (San José, Costa Rica))
Vitols, Sigurd (Karolinska University Hospital and Karolinska Institutet (Suecia))
Watine, Joseph (Hôpital La Chartreuse)
Tugwell, Peter (University of Ottawa)
Universitat Autònoma de Barcelona

Date:	2017
Abstract:	The aim of this paper is to describe a conceptual framework for how to consider health equity in the Grading Recommendations Assessment and Development Evidence (GRADE) guideline development process. Study Design and Setting Consensus-based guidance developed by the GRADE working group members and other methodologists. We developed consensus-based guidance to help address health equity when rating the certainty of synthesized evidence (i. e. , quality of evidence). When health inequity is determined to be a concern by stakeholders, we propose five methods for explicitly assessing health equity: (1) include health equity as an outcome; (2) consider patient-important outcomes relevant to health equity; (3) assess differences in the relative effect size of the treatment; (4) assess differences in baseline risk and the differing impacts on absolute effects; and (5) assess indirectness of evidence to disadvantaged populations and/or settings. The most important priority for research on health inequity and guidelines is to identify and document examples where health equity has been considered explicitly in guidelines. Although there is a weak scientific evidence base for assessing health equity, this should not discourage the explicit consideration of how guidelines and recommendations affect the most vulnerable members of society.
Rights:	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.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Applicability ; Equity ; GRADE ; Guidelines ; Health ; Indirectness ; Meta-analysis ; Subgroup analysis ; Systematic review
Published in:	Journal of clinical epidemiology, Vol. 90 (october 2017) , p. 76-83, ISSN 1878-5921

DOI: 10.1016/j.jclinepi.2017.01.015
PMID: 28389397

14 p, 461.5 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles