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A taxonomy and framework for identifying and developing actionable statements in guidelines suggests avoiding informal recommendations.
Lotfi, Tamara; Hajizadeh, Anisa; Moja, Lorenzo; Akl, Elie A; Piggott, Thomas; Kredo, Tamara; Langendam, Miranda W; Iorio, Alfonso; Klugar, Miloslav; Klugarová, Jitka; Neumann, Ignacio; Wiercioch, Wojtek; Leontiadis, Grigorios I; Mbuagbaw, Lawrence; Turgeon, Alexis F; Meerpohl, Joerg; Stevens, Adrienne; Brozek, Jan; Santesso, Nancy; Pottie, Kevin; Dewidar, Omar; Flottorp, Signe A; Karpusheff, Justine; Saz-Parkinson, Zuleika; Rojas, María X; Parmelli, Elena; Chu, Derek K; Tugwell, Peter; Welch, Vivian; Avey, Marc T; Brignardello-Petersen, Romina; Mathew, Joseph L; Munn, Zachary; Nieuwlaat, Robby; Ford, Nathan; Qaseem, Amir; Askie, Lisa M; Schünemann, Holger J.
  • Lotfi T; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton , ON, Canada.
  • Hajizadeh A; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada.
  • Moja L; Department of Health Product Policy and Standards, World Health Organization, Geneva, Switzerland.
  • Akl EA; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton , ON, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
  • Piggott T; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada.
  • Kredo T; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Clinical Pharmacology, Department of Medicine, Stellenbosch University, Cape Town, South Africa.
  • Langendam MW; Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
  • Iorio A; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Department of Medicine, McMaster University, Hamilton ,ON, Canada.
  • Klugar M; The Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech CEBHC: JBI Centre of Excellence, Masaryk University GRADE Centre); Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
  • Klugarová J; The Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech CEBHC: JBI Centre of Excellence, Masaryk University GRADE Centre); Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
  • Neumann I; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Department of Internal Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
  • Wiercioch W; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton , ON, Canada.
  • Leontiadis GI; Department of Medicine, McMaster University, Hamilton ,ON, Canada.
  • Mbuagbaw L; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Biostatistics Unit/The Research Institute, St Joseph's Healthcare, Hamilton ,ON, Canada.
  • Turgeon AF; Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City ,QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec - Université Laval Research Center, Québec City ,QC, Canada.
  • Meerpohl J; Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany; Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany.
  • Stevens A; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton , ON, Canada.
  • Brozek J; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton , ON, Canada.
  • Santesso N; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton , ON, Canada.
  • Pottie K; School of Epidemiology and Public Health, University of Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa; Bruyère Research Institute, Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Otta
  • Dewidar O; School of Epidemiology and Public Health, University of Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa; Bruyère Research Institute, Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Otta
  • Flottorp SA; Norwegian Institute of Public Health, Oslo, Norway; University of Oslo, Oslo, Norway.
  • Karpusheff J; National Institute for Health and Care Excellence, United Kingdom.
  • Saz-Parkinson Z; Instituto de Salud Carlos III, Agencia de Evaluación de Tecnologías Sanitarias. Madrid, Spain.
  • Rojas MX; Department of Clinical Epidemiology and Public Health, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau).
  • Parmelli E; European Commission, Joint Research Centre (JRC), Ispra, Italy.
  • Chu DK; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Department of Medicine, McMaster University, Hamilton ,ON, Canada.
  • Tugwell P; School of Epidemiology and Public Health, University of Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa; Bruyère Research Institute, Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Otta
  • Welch V; School of Epidemiology and Public Health, University of Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa; Bruyère Research Institute, Ottawa, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, University of Otta
  • Avey MT; Public Health Agency of Canada, Canada.
  • Brignardello-Petersen R; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada.
  • Mathew JL; Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  • Munn Z; Joanna Briggs Institute Faculty of Health and Medical Sciences The University of Adelaide, Australia.
  • Nieuwlaat R; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada.
  • Ford N; Department of HIV, Hepatitis and Sexually Transmitted Infections, World Health Organization, Geneva, Switzerland.
  • Qaseem A; American College of Physicians, Philadelphia, PA, USA.
  • Askie LM; Quality Assurance of Norms and Standards Department, Science Division, World Health Organization, Geneva, Switzerland.
  • Schünemann HJ; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton ,ON, Canada; Michael G. DeGroote Cochrane Canada and GRADE Centre, McMaster University, Hamilton , ON, Canada; Department of Medicine, McMaster University, Hamilton ,ON, Canada; Dipartimento di Scienze Biomedic
J Clin Epidemiol ; 141: 161-171, 2022 01.
Article in English | MEDLINE | ID: covidwho-1433469
ABSTRACT

OBJECTIVE:

To propose a taxonomy and framework that identifies and presents actionable statements in guidelines. STUDY DESIGN AND

SETTING:

We took an iterative approach reviewing case studies of guidelines produced by the World Health Organization and the American Society of Hematology to develop an initial conceptual framework. We then tested it using randomly selected recommendations from published guidelines addressing COVID-19 from different organizations, evaluated its results, and refined it before retesting. The urgency and availability of evidence for development of these recommendations varied. We consulted with experts in research methodology and guideline developers to improve the final framework.

RESULTS:

The resulting taxonomy and framework distinguishes five types of actional statements formal recommendations; research recommendations; good practice statements; implementation considerations, tools and tips; and informal recommendations. These statements should respond to a priori established criteria and require a clear structure and recognizable presentation in a guideline. Most importantly, this framework identifies informal recommendations that differ from formal recommendations by how they consider evidence and in their development process.

CONCLUSION:

The identification, standardization and explicit labelling of actionable statements according to the framework may support guideline developers to create actionable statements with clear intent, avoid informal recommendations and improve their understanding and implementation by users.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Clin Epidemiol Journal subject: Epidemiology Year: 2022 Document Type: Article Affiliation country: J.jclinepi.2021.09.028

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Clin Epidemiol Journal subject: Epidemiology Year: 2022 Document Type: Article Affiliation country: J.jclinepi.2021.09.028