Developing trustworthy recommendations as part of an urgent response (1–2 weeks): a GRADE concept paper
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OBJECTIVES: The aim of this study is to propose an approach for developing trustworthy recommendations as part of urgent responses (1-2 week) in the clinical, public health, and health systems fields. STUDY DESIGN AND SETTING: We conducted a review of the literature, outlined a draft approach, refined the concept through iterative discussions, a workshop by the Grading of Recommendations Assessment, Development and Evaluation Rapid Guidelines project group, and obtained feedback from the larger Grading of Recommendations Assessment, Development and Evaluation working group. RESULTS: A request for developing recommendations within 2 week is the usual trigger for an urgent response. Although the approach builds on the general principles of trustworthy guideline development, we highlight the following steps: (1) assess the level of urgency; (2) assess feasibility; (3) set up the organizational logistics; (4) specify the question(s); (5) collect the information needed; (6) assess the adequacy of identified information; (7) develop the recommendations using one of the 4 potential approaches: adopt existing recommendations, adapt existing recommendations, develop new recommendations using existing adequate systematic review, or develop new recommendations using expert panel input; and (8) consider an updating plan. CONCLUSION: An urgent response for developing recommendations requires building a cohesive, skilled, and highly motivated multidisciplinary team with the necessary clinical, scientific, and methodological expertise; adapting to shifting needs; complying with the principles of transparency; and properly managing conflicts of interest.
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Several published examples exist of GRADE being used in rapid reviews.
“Several examples have been published where the GRADE approach has been used for rapid reviews.[61][62][63]”
From Updated recommendations for the Cochrane rapid review methods guidance for rapid reviews of effectiveness (2024) · cites this paper as [63]
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- Authors
- Akl, E. A., Morgan, R. L., Rooney, A. A., Beverly, B., Katikireddi, S. V., Agarwal, A., Alper, B. S., Alva-Diaz, C., Amato, L., Ansari, M. T., Brozek, J., Chu, D. K., Dahm, P., Darzi, A. J., Falavigna, M., Gartlehner, G., Pardo-Hernandez, H., King, V., Klugarová, J., Langendam, M. W. M., Lockwood, C., Mammen, M., Mathioudakis, A. G., McCaul, M., Meerpohl, J. J., Minozzi, S., Mustafa, R. A., Nonino, F., Piggott, T., Qaseem, A., Riva, J., Rodin, R., Sekercioglu, N., Skoetz, N., Traversy, G., Thayer, K., & Schünemann, H.
- Affiliations
- McMaster University Medical Centre (CA)
- National Institute of Environmental Health Sciences (US)
- MRC/CSO Social and Public Health Sciences Unit (GB)
- University of Toronto (CA)
- EBSCO Industries (United States) (US)
- Regione Lazio (IT)
- University of Ottawa (CA)
- University of Minnesota (US)
- Hospital Moinhos de Vento (BR)
- Universität für Weiterbildung Krems (AT)
- Oregon Health & Science University (US)
- Masaryk University (CZ)
- Amsterdam University Medical Centers (NL)
- The University of Adelaide (AU)
- University at Buffalo, State University of New York (US)
- Manchester Academic Health Science Centre (GB)
- Stellenbosch University (ZA)
- University of Freiburg (DE)
- University of Milan (IT)
- University of Kansas Medical Center (US)
- Istituto delle Scienze Neurologiche di Bologna (IT)
- American College of Physicians (US)
- Public Health Agency of Canada (CA)
- University of Cologne (DE)
- Corresponding author
- Akl, Elie A.
- ORCID
- Akl, Elie A.
- Morgan, Rebecca L.
- Rooney, Andrew A.
- Katikireddi, Srinivasa Vittal
- Agarwal, Arnav
- Alper, Brian S.
- Amato, Laura
- Chu, Derek K.
- Dahm, Philipp
- Darzi, Andrea J.
- Falavigna, Maicon
- Gartlehner, Gerald
- Klugarová, Jitka
- Langendam, M.W. Miranda
- Lockwood, Craig
- Mammen, Manoj
- Mathioudakis, Alexander G.
- McCaul, Michael
- Meerpohl, Joerg J.
- Minozzi, Silvia
- Mustafa, Reem A.
- Nonino, Francesco
- Piggott, Thomas
- Qaseem, Amir
- Riva, John
- Sekercioglu, Nigar
- Skoetz, Nicole
- Schünemann, Holger
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 129
- Pages
- 1-11
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W3091337614
- Cited by
- 34
- References
- 43
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 9 · 2022: 7 · 2021: 11 · 2020: 1
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Clinical Epidemiology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Funders
- NIHR Manchester Biomedical Research Centre
- BRC
- NRS
- Medical Research Council
- Scottish Government
- Chief Scientist Office
- AllerGen
- Canadian Allergy, Asthma and Immunology Foundation
- CAAIF
- NCE
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- GRADE, guideline development, feasibility assessment, guideline revision, conflicts of interest, transparency, multidisciplinary team
- MeSH terms
- Systematic Reviews as Topic, Humans, Outcome Assessment, Health Care, Practice Guidelines as Topic, Evidence-Based Medicine, Information Management, Consensus
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