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 |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Katikireddi, Professor 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 > School of Health & 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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