GRADE equity guidelines 3: considering health equity in GRADE guideline development: rating the certainty of synthesized evidence

Welch, V. A. et al. (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. (doi: 10.1016/j.jclinepi.2017.01.015) (PMID:28389397) (PMCID:PMC5680526)

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Abstract

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:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Katikireddi, Dr Vittal
Authors: Welch, V. A., Akl, E. A., Pottie, K., Ansari, M. T., Briel, M., Christensen, R., Dans, A., Dans, L., Eslava-Schmalbach, J. H., Guyatt, G., Hultcrantz, M., Jull, J., Katikireddi, S. V., Lang, E., Matovinovic, E., Meerpohl, J. J., Morton, R., Mosdøl, A., Murad, M. H., Petkovic, J., Schünemann, H., Sharaf, R., Shea, B., Singh, J. A., Solà, I., Stanev, R., Stein, A. T., Thabane, L., Tonia, T., Tristan, M., Vitols, S., Watine, J., and Tugwell, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Journal of Clinical Epidemiology
Publisher:Elsevier
ISSN:0895-4356
ISSN (Online):1878-5921
Published Online:04 April 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Journal of Clinical Epidemiology 90:76-93
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
699162Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiScottish Executive Health Department (SEHHD-CSO)SCAF/15/02IHW - MRC/CSO SPHU
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
727671SPHSU Core Renewal: Informing Healthy Public Policy Research ProgrammePeter CraigMedical Research Council (MRC)MC_UU_12017/15IHW - MRC/CSO SPHU