Using GRADE in public-health guidelines – challenges and some solutions?

Article type
Authors
Katikireddi S1, Shaw B2, Thomson H3, Nolan K4, O'Neill P4, Hilton-Boon M1
1MRC/CSO Social & Public Health Sciences Unit, University of Glasgow
2NICE
3Cochrane Public Health
4The National Institute for Health and Care Excellence (NICE)
Abstract
Objectives: •Explore if and how GRADE approaches are applied to Public Health/ social Policy (PHP) guidelines.•Explore experiences and responses to challenges developers of PHP guidelines face in applying GRADE.
•Discuss how the GRADE PHP Working Group can support systematic reviewers and guideline developers.
Description: Developing PHP guidelines can be challenging for many reasons including: population-based intervention delivery; a highly heterogenous evidence base often constituted of non-randomised studies; the diverse range of stakeholders across multiple sectors; and the varying importance of outcomes to different stakeholders.
The workshop involves 3 parts:
1) Challenges introducing the GRADE approach to PHP in the UK (25 min).
Perceived challenges faced by the UK’s National Institute of Health and Care Excellence (NICE) will be presented and debated.
2) Detailed exploration of challenges developing PHP guidelines (45 min).
Attendees will consider in groups what challenges they are aware of, or anticipate experiencing, when using GRADE in PHP guidelines. Why some challenges occur to a lesser or greater extent than for clinical interventions will be explored, with reasoning elucidated through examples (inc from low/middle income countries).
3) Feedback and next steps (20 min).
The range of challenges faced and whether they can be met by existing GRADE approaches will be explored. We will finish by considering how a GRADE PHP group can support applying GRADE.