Use of evidence in WHO recommendations
Open accessAbstract
Background WHO regulations, dating back to 1951, emphasise the role of expert opinion in the development of recommendations. However, the organisation's guidelines, approved in 2003, emphasise the use of systematic reviews for evidence of effects, processes that allow for the explicit incorporation of other types of information (including values), and evidence-informed dissemination and implementation strategies. We examined the use of evidence, particularly evidence of effects, in recommendations developed by WHO departments.Methods We interviewed department directors (or their delegates) at WHO headquarters in Geneva, Switzerland, and reviewed a sample of the recommendation-containing reports that were discussed in the interviews (as well as related background documentation). Two individuals independently analysed the interviews and reviewed key features of the reports and background documentation.Findings Systematic reviews and concise summaries of findings are rarely used for developing recommendations. Instead, processes usually rely heavily on experts in a particular specialty, rather than representatives of those who will have to live with the recommendations or on experts in particular methodological areas.Interpretation Progress in the development, adaptation, dissemination, and implementation of recommendations for member states will need leadership, the resources necessary for WHO to undertake these processes in a transparent and defensible way, and close attention to the current and emerging research literature related to these processes.
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Without international guidelines, healthcare professionals in resource-strapped settings may rely on unvalidated information, leading to patient harm.
“Without international guidelines, healthcare professionals in already resource strapped settings may be pushed to rely on unvalidated information, leading to patient harm”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [32]
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- Authors
- Oxman, A. D., Lavis, J. N., & Fretheim, A.
- Affiliations
- Nasjonalt Kunnskapssenter for Helsetjenesten (NO)
- McMaster University (CA)
- Corresponding author
- Oxman, Andrew D
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2007-06
- Volume
- 369
- Issue
- 9576
- Pages
- 1883-1889
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2112003434
- Cited by
- 287
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 9 · 2023: 6 · 2022: 2 · 2021: 7 · 2020: 6 · 2019: 9 · 2018: 12 · 2017: 10 · 2016: 14 · 2015: 16 · 2014: 18 · 2013: 81 · 2012: 14
- FWCI
- 23.26
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- BIBSYS Brage (BIBSYS (Norway)) (acceptedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- World Health Organization, health advice, evidence use, systematic reviews, expert opinion, evidence-informed decision-making, WHO guidelines, dissemination and implementation
- MeSH terms
- Expert Testimony, Health Planning Guidelines, Health Policy, Humans, Interviews as Topic, Physician Executives, World Health Organization, Evidence-Based Medicine
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