Welch, Vivian A; Akl, Elie A; Pottie, Kevin; Ansari, Mohammed T; Briel, Matthias; Christensen, Robin; Dans, Antonio; Dans, Leonila; Eslava-Schmalbach, Javier; Guyatt, Gordon; Hultcrantz, Monica; Jull, Janet; Katikireddi, Srinivasa Vittal; Lang, Eddy; Matovinovic, Elizabeth; Meerpohl, Joerg J; Morton, Rachael L; Mosdol, Annhild; Murad, M Hassan; Petkovic, Jennifer; ... (2017). GRADE equity guidelines 3: considering health equity in GRADE guideline development: rating the certainty of synthesized evidence. Journal of clinical epidemiology, 90, pp. 76-83. Elsevier 10.1016/j.jclinepi.2017.01.015
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OBJECTIVES
The aim of this paper is to describe a conceptual framework for how to consider health equity in the Grading Recommendations Assessment and Development Evidence (GRADE) guideline development process.
STUDY DESIGN AND SETTING
Consensus-based guidance developed by the GRADE working group members and other methodologists.
RESULTS
We developed consensus-based guidance to help address health equity when rating the certainty of synthesized evidence (i.e., quality of evidence). When health inequity is determined to be a concern by stakeholders, we propose five methods for explicitly assessing health equity: (1) include health equity as an outcome; (2) consider patient-important outcomes relevant to health equity; (3) assess differences in the relative effect size of the treatment; (4) assess differences in baseline risk and the differing impacts on absolute effects; and (5) assess indirectness of evidence to disadvantaged populations and/or settings.
CONCLUSION
The most important priority for research on health inequity and guidelines is to identify and document examples where health equity has been considered explicitly in guidelines. Although there is a weak scientific evidence base for assessing health equity, this should not discourage the explicit consideration of how guidelines and recommendations affect the most vulnerable members of society.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) |
UniBE Contributor: |
Tonia, Thomai |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
0895-4356 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Tanya Karrer |
Date Deposited: |
09 Jan 2018 12:00 |
Last Modified: |
05 Dec 2022 15:08 |
Publisher DOI: |
10.1016/j.jclinepi.2017.01.015 |
PubMed ID: |
28389397 |
Uncontrolled Keywords: |
Applicability GRADE Guidelines Health Indirectness Meta-analysis Subgroup analysis Systematic review equity |
BORIS DOI: |
10.7892/boris.107280 |
URI: |
https://boris.unibe.ch/id/eprint/107280 |
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