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

J 2021

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

BOON, M. H., H. THOMSON, B. SHAW, E. A. AKL, S. K. LHACHIMI et. al.

Basic information

Original name

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

Authors

BOON, M. H. (guarantor), H. THOMSON, B. SHAW, E. A. AKL, S. K. LHACHIMI, J. LOPEZ-ALCALDE, Miloslav KLUGAR (203 Czech Republic, belonging to the institution), L. CHOI, Z. SAZ-PARKINSON, R. A. MUSTAFA, M. W. LANGENDAM, O. CRANE, R. L. MORGAN, E. REHFUESS, B. C. JOHNSTON, L. Y. CHONG, G. H. GUYATT, H. J. SCHUNEMANN and S. V. KATIKIREDDI

Edition

Journal of Clinical Epidemiology, NEW YORK, ELSEVIER SCIENCE INC, 2021, 0895-4356

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30304 Public and environmental health

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 7.407

RIV identification code

RIV/00216224:14110/21:00122119

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.jclinepi.2021.01.001

UT WoS

000678570200006

Keywords in English

GRADE; Public health; Guidelines; Nonrandomized studies; Health policy; Social determinants

Abstract

V originále

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. (C) 2021 The Author(s). Published by Elsevier Inc.

Citovat

BOON, M. H., H. THOMSON, B. SHAW, E. A. AKL, S. K. LHACHIMI, J. LOPEZ-ALCALDE, Miloslav KLUGAR, L. CHOI, Z. SAZ-PARKINSON, R. A. MUSTAFA, M. W. LANGENDAM, O. CRANE, R. L. MORGAN, E. REHFUESS, B. C. JOHNSTON, L. Y. CHONG, G. H. GUYATT, H. J. SCHUNEMANN and S. V. KATIKIREDDI. Challenges in applying the GRADE approach in public health guidelines and systematic reviews: a concept article from the GRADE Public Health Group. Journal of Clinical Epidemiology. NEW YORK: ELSEVIER SCIENCE INC, 2021, vol. 135, July 2021, p. 42-53. ISSN 0895-4356. Available from: https://dx.doi.org/10.1016/j.jclinepi.2021.01.001.

@article{1786784,
   author = {Boon, M. H. and Thomson, H. and Shaw, B. and Akl, E. A. and Lhachimi, S. K. and LopezandAlcalde, J. and Klugar, Miloslav and Choi, L. and SazandParkinson, Z. and Mustafa, R. A. and Langendam, M. W. and Crane, O. and Morgan, R. L. and Rehfuess, E. and Johnston, B. C. and Chong, L. Y. and Guyatt, G. H. and Schunemann, H. J. and Katikireddi, S. V.},
   article_location = {NEW YORK},
   article_number = {July 2021},
   doi = {http://dx.doi.org/10.1016/j.jclinepi.2021.01.001},
   keywords = {GRADE; Public health; Guidelines; Nonrandomized studies; Health policy; Social determinants},
   language = {eng},
   issn = {0895-4356},
   journal = {Journal of Clinical Epidemiology},
   title = {Challenges in applying the GRADE approach in public health guidelines and systematic reviews: a concept article from the GRADE Public Health Group},
   url = {https://www.sciencedirect.com/science/article/pii/S0895435621000032?via%3Dihub},
   volume = {135},
   year = {2021}
}

TY  - JOUR
ID  - 1786784
AU  - Boon, M. H. - Thomson, H. - Shaw, B. - Akl, E. A. - Lhachimi, S. K. - Lopez-Alcalde, J. - Klugar, Miloslav - Choi, L. - Saz-Parkinson, Z. - Mustafa, R. A. - Langendam, M. W. - Crane, O. - Morgan, R. L. - Rehfuess, E. - Johnston, B. C. - Chong, L. Y. - Guyatt, G. H. - Schunemann, H. J. - Katikireddi, S. V.
PY  - 2021
TI  - Challenges in applying the GRADE approach in public health guidelines and systematic reviews: a concept article from the GRADE Public Health Group
JF  - Journal of Clinical Epidemiology
VL  - 135
IS  - July 2021
SP  - 42-53
EP  - 42-53
PB  - ELSEVIER SCIENCE INC
SN  - 08954356
KW  - GRADE
KW  - Public health
KW  - Guidelines
KW  - Nonrandomized studies
KW  - Health policy
KW  - Social determinants
UR  - https://www.sciencedirect.com/science/article/pii/S0895435621000032?via%3Dihub
N2  - 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. (C) 2021 The Author(s). Published by Elsevier Inc.
ER  -

BOON, M. H., H. THOMSON, B. SHAW, E. A. AKL, S. K. LHACHIMI, J. LOPEZ-ALCALDE, Miloslav KLUGAR, L. CHOI, Z. SAZ-PARKINSON, R. A. MUSTAFA, M. W. LANGENDAM, O. CRANE, R. L. MORGAN, E. REHFUESS, B. C. JOHNSTON, L. Y. CHONG, G. H. GUYATT, H. J. SCHUNEMANN and S. V. KATIKIREDDI. Challenges in applying the GRADE approach in public health guidelines and systematic reviews: a concept article from the GRADE Public Health Group. \textit{Journal of Clinical Epidemiology}. NEW YORK: ELSEVIER SCIENCE INC, 2021, vol.~135, July 2021, p.~42-53. ISSN~0895-4356. Available from: https://dx.doi.org/10.1016/j.jclinepi.2021.01.001.

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