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Addressing Challenges When Applying GRADE to Public Health Guidelines: A Scoping Review Protocol and Pilot Analysis.

ABSTRACT: This is a protocol for a scoping review that aims to determine how guideline authors using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach have addressed previously identified challenges related to public health. The Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed. We will search and screen titles of guidelines for all languages published in 2013-2021 in: the GIN library, BIGG database, Epistemonikos GRADE guidelines repository, GRADEpro Database, MAGICapp, NICE and WHO websites. Two reviewers will independently screen full texts of the documents identified. The following information will be extracted: methods used for identifying different stakeholders and incorporating their perspectives; methods for identification and prioritization of non-health outcomes; methods for determining thresholds for decision-making; methods for incorporating and grading evidence from non-randomized studies; methods for addressing concerns with conditional recommendations in public health; methods for reaching consensus; additional methodological concerns; and any modifications made to GRADE. A combination of directed content analysis and descriptive statistics will be used for data analysis, and the findings presented narratively in a tabular and graphical form. In this protocol, we present the pilot results from 13 identified eligible guidelines issued between January and August 2021. We will publish the full review results when they become available.

SUBMITTER: Kantorova L

PROVIDER: S-EPMC8775462 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Addressing Challenges When Applying GRADE to Public Health Guidelines: A Scoping Review Protocol and Pilot Analysis.

Kantorová Lucia L Friessová Tereza T Slezáková Simona S Langaufová Alena A Kantor Jiří J Munn Zachary Z Barker Timothy Hugh TH Katikireddi Srinivasa Vittal SV Mustafa Reem A RA Žuljević Marija Franka MF Lukežić Marina M Klugarová Jitka J Riad Abanoub A Vrbová Tereza T Pokorná Andrea A Búřilová Petra P Búřil Jiří J Kirkovski Aleksandar A Ćaćić Nensi N Delač Ljerka L Tokalić Ružica R Poklepović Peričić Tina T Klugar Miloslav M

International journal of environmental research and public health 20220116 2

This is a protocol for a scoping review that aims to determine how guideline authors using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach have addressed previously identified challenges related to public health. The Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed. We will search and screen titles of guidelines for all languages published in 2013-2021 in: the GIN library, BIGG database, Epistemonikos GRADE guidelines reposi ...[more]

PMID: 35055814

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Project description:BackgroundThe Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been adopted by many national and international organisations as a systematic and transparent framework for evidence-based guideline development. With reference to an ongoing debate in the literature and within public health organisations, this study reviews current experience with the GRADE approach in rating the quality of evidence in the field of public health and identifies challenges encountered.MethodsWe conducted semi-structured interviews with individuals/groups that have applied the GRADE approach in the context of systematic reviews or guidelines in the field of public health, as well as with representatives of groups or organisations that actively decided against its use. We initially contacted potential participants by email. Responses were obtained by telephone interview or email, and written interview summaries were validated with participants. We analysed data across individual interviews to distil common themes and challenges.ResultsBased on 25 responses, we undertook 18 interviews and obtained 15 in-depth responses relating to specific systematic reviews or guideline projects; a majority of the latter were contributed by groups within the World Health Organization. All respondents that have used the GRADE approach appreciated the systematic and transparent process of assessing the quality of the evidence. However, respondents reported a range of minor and major challenges relating to complexity of public health interventions, choice of outcomes and outcome measures, ability to discriminate between different types of observational studies, use of non-epidemiological evidence, GRADE terminology and the GRADE and guideline development process. Respondents' suggestions to make the approach more applicable to public health interventions included revisiting terminology, offering better guidance on how to apply GRADE to complex interventions and making modifications to the current grading scheme.ConclusionsOur findings suggest that GRADE principles are applicable to public health and well-received but also highlight common challenges. They provide a starting point for exploring options for improvements and, where applicable, testing these across different types of public health interventions. Several public health organisations are currently testing GRADE, and the GRADE Working Group is eager to engage with these groups to find ways to address concerns.

Project description:BackgroundCo-creation engages diverse stakeholders, including marginalized populations, in collaborative problem-solving to enhance engagement and develop contextually appropriate solutions. It is increasingly recognized as a way to democratize research and improve the impact of interventions, services, and policies. However, the lack of synthesized evidence on co-creation methods limits methodological rigor and the establishment of best practices. This review aimed to identify co-creation methods in academic literature and analyze their characteristics, target groups, and associated benefits and challenges.MethodsThis scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The search was conducted in the Health CASCADE database v1.5 (including CINAHL, PubMed, and 17 additional databases via ProQuest) from January 1970 to March 2022. Data was aggregated and summarized, with qualitative data analyzed using Braun and Clarke's six-phase thematic analysis approach.ResultsThe review included 266 articles, identifying 248 distinct co-creation methods published between 1998 and 2022. Most methods were rooted in participatory paradigms (147 methods), with 49 methods derived from co-approaches like co-creation, co-design, and co-production, and 11 from community-based health promotion and action research. Methods were applied across 40 target populations, including children, adults, and marginalized groups. Many methods (62.3%) were delivered face-to-face, with 40 articles incorporating digital tools. Thematic analysis revealed nine benefits, such as enhanced creativity, empowerment, and improved communication, and six challenges, including resource constraints and systemic and structural barriers.ConclusionThis review emphasizes the importance of robust documentation and analysis of co-creation methods to inform their application in public health. Findings support the development of collaborative co-creation processes that are responsive to the needs of diverse populations, thereby enhancing the overall effectiveness and cultural sensitivity of the outcomes. This review highlights the potential of co-creation methods to promote equity and inclusion while emphasizing the importance of evaluating and selecting methods tailored to specific objectives, offering a critical resource for planning, conducting, and evaluating co-creation projects.

Project description:BackgroundPharmacy interventions are a subset of public health interventions and its research is usually performed within the scope of a trial. The economic evaluation of pharmacy interventions requires certain considerations which have some similarities to those of public health interventions and to economic evaluations alongside trials. The objective of this research is to perform an overview of systematic reviews of economic evaluations of pharmacy services and triangulate results with recommendations for economic evaluations of both public health interventions and alongside trials.Methods(1) Exploratory review of recommendations on the economic evaluation of public health interventions, (2) exploratory review of recommendations for conducting economic evaluations alongside trials, (3) overview of systematic reviews of economic evaluations of pharmacy interventions (protocol registered with PROSPERO 2016 outlining information sources, inclusion criteria, appraisal of reviews and synthesis methods).ResultsFourteen systematic reviews containing 75 index publications were included. Reviews reported favorable economic findings for 71% of studies with full economic evaluations. The types of economic analysis are diverse. Two critical quality domains are absent from most reviews. Key findings include the following: certain types of risk of bias, wider scope of study designs, and most economic quality criteria met but some issues unresolved or unclear. Triangulation revealed additional gaps. Limitations include choice of critical quality domains and potential biases in the overview process.ConclusionsEconomic evaluations of pharmacy-based public health interventions seem to follow most economic quality criteria, but there are still some issues in certain key areas to improve. These findings may assist in improving the design of pilot trials of economic evaluations in pharmacy, leading to robust evidence for payers. Based on the findings, we propose a methodological approach for the economic evaluation of pharmacy-based public health interventions.Systematic review registrationPROSPERO CRD42016032768.

Project description:IntroductionMuch is known around public health preparedness and response phases. However, between the two phases is operational readiness that comprises the immediate actions needed to respond to a developing risk or hazard. Currently, emergency readiness is embedded in multiple frameworks and policy documents related to the health emergency cycle. However, knowledge about operational readiness' critical readiness components and actions required by countries to respond to public health eminent threat is not well known. Therefore, we aim to define and identify the critical elements of 'operational readiness' for public health emergencies, including COVID-19, and identify lessons learnt from addressing it, to inform the WHO Operational Readiness Framework.Methods and analysisThis is a scoping review following the Joanna Briggs Institute guidance. Reporting will be according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. MEDLINE, Embase and Web of Science databases and grey literature will be searched and exported into an online systematic review software (eg, Rayyan in this case) for review. The review team, which apart from scoping review methodological experts include content experts in health systems and public health and emergency medicine, prepared an a priori study protocol in consultation with WHO representatives. ATLAS.ti V.9 will be used to conduct thematic data analysis as well as store, organise and retrieve data. Data analysis and presentation will be carried out by five reviewers.Ethics and disseminationThis review will reveal new insights, knowledge and lessons learnt that will translate into an operational framework for readiness actions. In consultation with WHO, findings will be disseminated as appropriate (eg, through professional bodies, conferences and research papers). No ethics approvals are required as no humans will be involved in data collection.Protocol registrationThis rapid scoping review has been registered on Open Science Framework (doi:10.17605/OSF.IO/6SYAH).

Project description:IntroductionPrecision public health is an emerging and evolving field. Academic communities are divided regarding terminology and definitions, and what the scope, parameters and goals of precision public health should include. This protocol summarises the procedure for a scoping review which aims to identify and describe definitions, terminology, uses of the term and concepts in current literature.Methods and analysisA scoping review will be undertaken to gather existing literature on precision public health. We will search CINAHL, PubMed, Scopus, Web of Science and Google Scholar, and include all documents published in English that mention precision public health. A critical discourse analysis of the resulting papers will generate an account of precision public health terminology, definitions and uses of the term and the use and meaning of language. The analysis will occur in stages: first, descriptive information will be extracted and descriptive statistics will be calculated in order to characterise the literature. Second, occurrences of the phrase 'precision public health' and alternative terms in documents will be enumerated and mapped, and definitions collected. The third stage of discourse analysis will involve analysis and interpretation of the meaning of precision public health, including the composition, organisation and function of discourses. Finally, discourse analysis of alternative phrases to precision public health will be undertaken. This will include analysis and interpretation of what alternative phrases to precision public health are used to mean, how the phrases relate to each other and how they are compared or contrasted to precision public health. Results will be grouped under headings according to how they answer the research questions.Ethics and disseminationNo ethical approval will be required for the scoping review. Results of the scoping review will be used as part of a doctoral thesis, and may be published in journals, conference proceedings or elsewhere.

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Addressing Challenges When Applying GRADE to Public Health Guidelines: A Scoping Review Protocol and Pilot Analysis.

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Addressing Challenges When Applying GRADE to Public Health Guidelines: A Scoping Review Protocol and Pilot Analysis.

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