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J Clin Epidemiol. 2017 Oct;90:68-75. doi: 10.1016/j.jclinepi.2017.01.017. Epub 2017 May 9.

GRADE equity guidelines 2: considering health equity in GRADE guideline development: equity extension of the guideline development checklist.

Author information

1
Clinical Research Institute, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon; Department of Medicine, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon; AUB GRADE Center, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon. Electronic address: ea32@aub.edu.lb.
2
Bruyére Research Institute, Bruyére Continuing Care and University of Ottawa, Bruyère St., Ottawa, Ontario, K1N 5C8, Canada.
3
Centre for Global Health, Institute of Population Health, University of Ottawa, 43 Bruyère St, Ottawa, Ontario, K1N 5C8, Canada.
4
Group of Equity in Health, Faculty of Medicine, Universidad Nacional de Colombia, Edif. Uriel Gutiérrez, Bogotá D.C., Colombia; Technology Development Center, Sociedad Colombiana de Anestesiologia y Reanimacion, Sociedad Colombiana de Anestesiología y ReanimaciónCra, 15 A No 120-74, Piso 4y5, Edif. Concord Center, Santa Fe de Bogotá, Colombia.
5
Clinical Research Institute, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon; AUB GRADE Center, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon.
6
Clinical Epidemiology and Public Health Department, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), C/Sant Antoni Maria Claret, 167, Pavelló 18, planta 0, 08025 Barcelona, Spain.
7
Public Health MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 200, Renfield Street, Glasgow G2 3QB, Scotland.
8
Department of Medicine, School of Medicine, Birmingham VA Medical Center, 700 19th St S, Birmingham, AL 35233, USA; Division of Epidemiology, School of Public Health, University of Alabama at Birmingham (UAB), 1720 2nd Ave S, Birmingham, AL 35294, USA; Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 5777 E. Mayo Blvd., Phoenix, AZ 85054, USA.
9
Mayo Clinic Evidence-based Practice Center, Preventive Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
10
Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité-U1153, Inserm/Université Paris Descartes, 1 place du Parvis Notre-Dame, 75004 Paris, France; Cochrane France, Hôpital Hôtel-Dieu, 1 place du Parvis Notre Dame, 75181 Paris, Cedex 04, France; Cochrane Germany, Medical Center-University of Freiburg, Breisacher Strasse 153, 79110 Freiburg, Germany.
11
Institute of Technology, University of Washington, Tacoma, Washington, USA.
12
Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW Calgary, Alberta, T2N 4N1, Canada.
13
Faculty of Medicine, Chiang Mai University, Su Thep, Mueang Chiang Mai District, Chiang Mai 50200, Thailand.
14
Ottawa Hospital Research Institute, University of Ottawa, 75 Laurier Ave E, Ottawa, Ontario, K1N 6N5, Canada.
15
Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, Hamilton, 1280 Main St., W.Hamilton, Ontario, L8S 4K1, Canada; Department of Medicine, Faculty of Health Sciences, Hamilton, 1280 Main St., W. Hamilton, Ontario, L8S 4K1, Canada.
16
Socialstyrelsen, Rålambsvägen 3, Stockholm, 112 59, Sweden.
17
Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, Hamilton, 1280 Main St., W.Hamilton, Ontario, L8S 4K1, Canada; Department of Medicine, Faculty of Health Sciences, Hamilton, 1280 Main St., W. Hamilton, Ontario, L8S 4K1, Canada; Evidence Based Dentistry Unit, Faculty of Dentistry, University of Chile, Av. Libertador Bernardo O'Higgins, Santiago 1058, Chile.
18
Department of Neurology, Charleston Area Medical Center, 1201 Washington Street East, Suite 100, Charleston, WV 25301, USA.
19
Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Rd, Manchester M13 9PL, UK.
20
Public Health Ufcspa, Ulbra and Conceicao Hospital, Av. Farroupilha, 8001, Bairro São José, Canoas (RS), Brasil.
21
Long Island Jewish Medical Center North Shore University Hospital, 270-05 76th Ave, Queens, NY 11040, USA.
22
Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Spitalstrasse 21, 4056 Basel, Switzerland.
23
Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, Hamilton, 1280 Main St., W.Hamilton, Ontario, L8S 4K1, Canada; Department of Medicine, Faculty of Health Sciences, Hamilton, 1280 Main St., W. Hamilton, Ontario, L8S 4K1, Canada; McMaster GRADE Center, McMaster University, 1280 Main St W, Hamilton, Ontario, L8S 4L8, Canada; Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario, L8S 4L8, Canada.
24
The Centre for Global Health, Institute of Population Health, University of Ottawa, 75 Laurier Ave E, Ottawa, Ontario, K1N 6N5, Canada.

Abstract

OBJECTIVE:

To provide guidance for guideline developers on how to consider health equity at key stages of the guideline development process.

STUDY DESIGN AND SETTING:

Literature review followed by group discussions and consensus building.

RESULTS:

The key stages at which guideline developers could consider equity include setting priorities, guideline group membership, identifying the target audience(s), generating the guideline questions, considering the importance of outcomes and interventions, deciding what evidence to include and searching for evidence, summarizing the evidence and considering additional information, wording of recommendations, and evaluation and use. We provide examples of how guidelines have actually considered equity at each of these stages.

CONCLUSION:

Guideline projects should consider the aforementioned suggestions for recommendations that are equity sensitive.

KEYWORDS:

Disadvantaged; GRADE; Guidelines; Health equity; Special populations; Underserved

PMID:
28499847
DOI:
10.1016/j.jclinepi.2017.01.017
[Indexed for MEDLINE]

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