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 Dewidar, Omar
A1 Lotfi, Tamara
A1 Langendam, Miranda W
A1 Parmelli, Elena
A1 Saz Parkinson, Zuleika
A1 Solo, Karla
A1 Chu, Derek K
A1 Mathew, Joseph L
A1 Akl, Elie A
A1 Brignardello-Petersen, Romina
A1 Mustafa, Reem A
A1 Moja, Lorenzo
A1 Iorio, Alfonso
A1 Chi, Yuan
A1 Canelo-Aybar, Carlos
A1 Kredo, Tamara
A1 Karpusheff, Justine
A1 Turgeon, Alexis F
A1 Alonso-Coello, Pablo
A1 Wiercioch, Wojtek
A1 Gerritsen, Annette
A1 Klugar, Miloslav
A1 Rojas, María Ximena
A1 Tugwell, Peter
A1 Welch, Vivian Andrea
A1 Pottie, Kevin
A1 Munn, Zachary
A1 Nieuwlaat, Robby
A1 Ford, Nathan
A1 Stevens, Adrienne
A1 Khabsa, Joanne
A1 Nasir, Zil
A1 Leontiadis, Grigorios
A1 Meerpohl, Joerg
A1 Piggott, Thomas
A1 Qaseem, Amir
A1 Matthews, Micayla
A1 Schünemann, Holger J
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.