GRADE equity guidelines 3: considering health equity in GRADE guideline development: rating the certainty of synthesized evidence.
J Clin Epidemiol
; 90: 76-83, 2017 Oct.
Article
en En
| MEDLINE
| ID: mdl-28389397
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 ANDSETTING:
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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Literatura de Revisión como Asunto
/
Guías de Práctica Clínica como Asunto
/
Equidad en Salud
/
Poblaciones Vulnerables
Tipo de estudio:
Guideline
/
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Clin Epidemiol
Asunto de la revista:
EPIDEMIOLOGIA
Año:
2017
Tipo del documento:
Article