Table 1

GRADE criteria for evaluating GPS modified from reference8*

Signalling question*Description
Is the statement clear and actionable?Specific statement that includes the specification of the population of interest.
Is the message really necessary in regard to actual healthcare practice?Without the guidance provided by the statement, clinicians might fail to take the appropriate action. Knowledge of that practice among the clinicians who represent the target audience is suboptimal.
After consideration of all relevant outcomes and potential downstream consequences, implementing the good practice statement results in a large net positive consequence?Certainty of benefits and harms are great; the values and preferences are clear; the intervention is cost saving; and the intervention is clearly acceptable, feasible and promotes equity.
Is collecting and summarising the evidence a poor use of a guideline panel’s limited time, energy, or resources (opportunity cost is large)?Poor use of a guideline panel’s time and resources to collect and link the indirect evidence is an issue of opportunity cost and their time and energy better spent on other efforts to maximise the guideline’s methodologic quality and over-all trustworthiness.
Is there a well-documented clear and explicit rationale connecting the indirect evidence?The rationale should include an explicit statement of the chain of evidence that supports the recommendation.
  • *The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group developed these criteria for guideline developers (to designate GPS in their guidelines) and those evaluating the appropriateness of GPS. All five criteria should be fulfilled to designate a statement as GPS.

  • GPS, good practice statement.