RT Journal Article SR Electronic T1 Good or best practice statements: proposal for the operationalisation and implementation of GRADE guidance JF BMJ Evidence-Based Medicine JO BMJ EBM FD BMJ Publishing Group Ltd SP 189 OP 196 DO 10.1136/bmjebm-2022-111962 VO 28 IS 3 A1 Omar Dewidar A1 Tamara Lotfi A1 Miranda W Langendam A1 Elena Parmelli A1 Zuleika Saz Parkinson A1 Karla Solo A1 Derek K Chu A1 Joseph L Mathew A1 Elie A Akl A1 Romina Brignardello-Petersen A1 Reem A Mustafa A1 Lorenzo Moja A1 Alfonso Iorio A1 Yuan Chi A1 Carlos Canelo-Aybar A1 Tamara Kredo A1 Justine Karpusheff A1 Alexis F Turgeon A1 Pablo Alonso-Coello A1 Wojtek Wiercioch A1 Annette Gerritsen A1 Miloslav Klugar A1 María Ximena Rojas A1 Peter Tugwell A1 Vivian Andrea Welch A1 Kevin Pottie A1 Zachary Munn A1 Robby Nieuwlaat A1 Nathan Ford A1 Adrienne Stevens A1 Joanne Khabsa A1 Zil Nasir A1 Grigorios Leontiadis A1 Joerg Meerpohl A1 Thomas Piggott A1 Amir Qaseem A1 Micayla Matthews A1 Holger J Schünemann A1 , YR 2023 UL http://ebm.bmj.com/content/28/3/189.abstract AB An evidence-based approach is considered the gold standard for health decision-making. Sometimes, a guideline panel might judge the certainty that the desirable effects of an intervention clearly outweigh its undesirable effects as high, but the body of supportive evidence is indirect. In such cases, the application of the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach for grading the strength of recommendations is inappropriate. Instead, the GRADE Working Group has recommended developing ungraded best or good practice statement (GPS) and developed guidance under which circumsances they would be appropriate.Through an evaluation of COVID-1- related recommendations on the eCOVID Recommendation Map (COVID-19.recmap.org), we found that recommendations qualifying a GPS were widespread. However, guideline developers failed to label them as GPS or transparently report justifications for their development. We identified ways to improve and facilitate the operationalisation and implementation of the GRADE guidance for GPS.Herein, we propose a structured process for the development of GPSs that includes applying a sequential order for the GRADE guidance for developing GPS. This operationalisation considers relevant evidence-to-decision criteria when assessing the net consequences of implementing the statement, and reporting information supporting judgments for each criterion. We also propose a standardised table to facilitate the identification of GPS and reporting of their development. This operationalised guidance, if endorsed by guideline developers, may palliate some of the shortcomings identified. Our proposal may also inform future updates of the GRADE guidance for GPS.No data are available.