GRADE equity guidelines 4: considering health equity in GRADE guideline development: evidence to decision process
Open accessAbstract
Objectives The aim of this paper is to provide detailed guidance on how to incorporate health equity within the GRADE (Grading Recommendations Assessment and Development Evidence) evidence to decision process. Study design and setting We developed this guidance based on the GRADE evidence to decision framework, iteratively reviewing and modifying draft documents, in person discussion of project group members and input from other GRADE members. Results Considering the impact on health equity may be required, both in general guidelines and guidelines that focus on disadvantaged populations. We suggest two approaches to incorporate equity considerations: (1) assessing the potential impact of interventions on equity and (2) incorporating equity considerations when judging or weighing each of the evidence to decision criteria. We provide guidance and include illustrative examples. Conclusion Guideline panels should consider the impact of recommendations on health equity with attention to remote and underserviced settings and disadvantaged populations. Guideline panels may wish to incorporate equity judgments across the evidence to decision framework. This is the fourth and final paper in a series about considering equity in the GRADE guideline development process. This series is coming from the GRADE equity subgroup.
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A proposal has been made and implemented with the Development of Equity focused Clinical Practice Guidelines under the GRADE approach, although it does not relate specifically to implementation research for health programs or interventions.
“A proposal has been made and implemented with the Development of Equity focused Clinical Practice Guidelines under the GRADE approach [43–47], although it does not relate specifically to implementation research for health programs or interventions.”
From Conceptual framework of equity-focused implementation research for health programs (EquIR) (2019) · cites this paper as [47]
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- Authors
- Pottie, K., Welch, V., Morton, R., Akl, E. A., Eslava-Schmalbach, J. H., Katikireddi, V., Singh, J., Moja, L., Lang, E., Magrini, N., Thabane, L., Stanev, R., Matovinovic, E., Snellman, A., Briel, M., Shea, B., Tugwell, P., Schunemann, H., Guyatt, G., & Alonso-Coello, P.
- Affiliations
- University of Ottawa (CA)
- The University of Sydney (AU)
- American University of Beirut (LB)
- Universidad Nacional de Colombia (CO)
- University of Alabama (US)
- World Health Organization (CH)
- University of Calgary (CA)
- St. Joseph’s Healthcare Hamilton (CA)
- Chiang Mai University (TH)
- SBU - Swedish Agency for Health Technology Assessment and Assessment of Social Services (SE)
- University of Basel (CH)
- McMaster University (CA)
- Corresponding author
- Pottie, Kevin
- ORCID
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2017-10
- Volume
- 90
- Pages
- 84-91
- ISSN
- 0895-4356 (ISSN-L)
- PMC
- PMC6538528
- OpenAlex
- W2766233621
- Cited by
- 80
- References
- 26
- Citations by year
- 2026: 4 · 2025: 16 · 2024: 15 · 2023: 7 · 2022: 8 · 2021: 11 · 2020: 8 · 2019: 6 · 2018: 4 · 2017: 1
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- World Health Organization
- Medical Research Council (MC_UU_12017/13, MC_UU_12017/15)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- health equity, GRADE, guideline development, disadvantaged groups, underserved populations, remote settings
- MeSH terms
- Health Equity, Decision Making, Humans, Research Design, Practice Guidelines as Topic, Vulnerable Populations, Evidence-Based Practice
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