Article type
Abstract
Background
Healthcare decision-making should be evidence based and incorporate wider contextual issues. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence to decision (EtD) framework provides a systematic, transparent format to evaluate the available evidence in a balanced way, to facilitate robust decision-making. While the EtD was developed with clinical guidelines in mind, it can be applied to a broad range of situations, such as public health or health policy decision-making.
Objective
We present two case studies describing the adaptation and use of the GRADE EtD framework to facilitate the operation of two different expert advisory groups (EAGs).
Methods
We modified the GRADE EtD framework to facilitate the presentation and discussion of evidence at two standing EAGs. The EAGs, which included patient/public representation, were convened to inform advice or recommendations on topics related to COVID-19 and medical exposures to ionising radiation (MEIR), respectively. We modified the EtD to focus on key relevant questions. Training was provided to EAGs before the EtD framework was used in practice. We then surveyed both EAGs to assess their satisfaction and to identify areas for improvement.
Results
The EtD framework was successfully adapted and used to facilitate discussions at 22 and four EAG meetings related to COVID-19 and MEIR, respectively. The EtD framework allowed flexibility in evaluating different forms of evidence synthesis, including rapid reviews, modelling studies and an overview of reviews. All (100%) of MEIR survey respondents either agreed or strongly agreed that the EAG meetings were well structured and organised, that they felt able to participate fully in the process and that their views were actively sought, and carefully considered. All (100%) of COVID survey respondents either agreed or strongly agreed that their contributions were carefully considered, and that the advice generated, was clear, balanced and appropriate. Positive feedback was also received from the relevant final decision-maker for both EAGs.
Conclusions
The EtD framework is flexible and can be adapted to diverse situations to facilitate consideration of wider areas of concern, ensuring input from all relevant stakeholders including patients and members of the public.
Healthcare decision-making should be evidence based and incorporate wider contextual issues. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence to decision (EtD) framework provides a systematic, transparent format to evaluate the available evidence in a balanced way, to facilitate robust decision-making. While the EtD was developed with clinical guidelines in mind, it can be applied to a broad range of situations, such as public health or health policy decision-making.
Objective
We present two case studies describing the adaptation and use of the GRADE EtD framework to facilitate the operation of two different expert advisory groups (EAGs).
Methods
We modified the GRADE EtD framework to facilitate the presentation and discussion of evidence at two standing EAGs. The EAGs, which included patient/public representation, were convened to inform advice or recommendations on topics related to COVID-19 and medical exposures to ionising radiation (MEIR), respectively. We modified the EtD to focus on key relevant questions. Training was provided to EAGs before the EtD framework was used in practice. We then surveyed both EAGs to assess their satisfaction and to identify areas for improvement.
Results
The EtD framework was successfully adapted and used to facilitate discussions at 22 and four EAG meetings related to COVID-19 and MEIR, respectively. The EtD framework allowed flexibility in evaluating different forms of evidence synthesis, including rapid reviews, modelling studies and an overview of reviews. All (100%) of MEIR survey respondents either agreed or strongly agreed that the EAG meetings were well structured and organised, that they felt able to participate fully in the process and that their views were actively sought, and carefully considered. All (100%) of COVID survey respondents either agreed or strongly agreed that their contributions were carefully considered, and that the advice generated, was clear, balanced and appropriate. Positive feedback was also received from the relevant final decision-maker for both EAGs.
Conclusions
The EtD framework is flexible and can be adapted to diverse situations to facilitate consideration of wider areas of concern, ensuring input from all relevant stakeholders including patients and members of the public.