Article type
Abstract
Background: Practice guidelines have the potential to reduce health inequities between people and groups. However, evidence about equity consideration in guideline development is lacking.
Objective: To identify and evaluate methodological considerations within guidance that are relevant to improving equity in guideline development.
Methods: We compiled a comprehensive list of organizations using different resources (eg, organizations listed on the GIN and Guideline Central websites and organizations addressed in previous similar studies) and retrieved their methodological guidance (ie, handbooks) on guideline development. We screened organizations’ guidance and abstracted data in duplicate and independently. We abstracted information pertaining to equity-related terms and PROGRESS-Plus populations. We mapped equity considerations to the topics of the GIN-McMaster guideline development checklist.
Results: Of 133 identified guidance from organizations, 53% addressed equity in at least one of the topics of the GIN-McMaster checklist. Most of these organizations were professional (56%), national (77%), and based in North America (40%), with the median publication year being 2019 (IQR = 2015-2020). The median number of topics addressed per guidance from an organization was 2 (IQR = 1-3). The highest proportion of organizations considering equity in relation to “guideline group membership” (58%) and “developing recommendations and determining their strength” (38%). Few organizations considered equity in relation to “reporting and peer review” (6%), “updating” (6%), “organization budget planning and training” (4%), and “establishing guideline group processes” (4%), and none considered equity in relation to “conflict of interest.” Relevant terms used included equality, disparities, and minorities. The handbooks addressed a median of 3 (IQR = 1-4) PROGRESS-PLUS groups per guidance. The majority considered “gender/sex” (61%), “race/ethnicity/culture/language” (58%), “personal characteristics associated with discrimination” (56%), and “place of residence” (55%) in their equity guidance. Few handbooks considered “social capital” (6%) and “features of relationships” (7%).
Conclusion: Approximately half of guideline-producing organizations consider equity in guideline development, with considerations limited to a few groups of populations and a few steps in the guideline development process.
Patient Relevance and Involvement: This review will help organizations reevaluate their guideline development processes and reformulate them to better consider vulnerable populations, thus ensuring integrity in patients’ evaluation and management. There was no public involvement in this review.
Objective: To identify and evaluate methodological considerations within guidance that are relevant to improving equity in guideline development.
Methods: We compiled a comprehensive list of organizations using different resources (eg, organizations listed on the GIN and Guideline Central websites and organizations addressed in previous similar studies) and retrieved their methodological guidance (ie, handbooks) on guideline development. We screened organizations’ guidance and abstracted data in duplicate and independently. We abstracted information pertaining to equity-related terms and PROGRESS-Plus populations. We mapped equity considerations to the topics of the GIN-McMaster guideline development checklist.
Results: Of 133 identified guidance from organizations, 53% addressed equity in at least one of the topics of the GIN-McMaster checklist. Most of these organizations were professional (56%), national (77%), and based in North America (40%), with the median publication year being 2019 (IQR = 2015-2020). The median number of topics addressed per guidance from an organization was 2 (IQR = 1-3). The highest proportion of organizations considering equity in relation to “guideline group membership” (58%) and “developing recommendations and determining their strength” (38%). Few organizations considered equity in relation to “reporting and peer review” (6%), “updating” (6%), “organization budget planning and training” (4%), and “establishing guideline group processes” (4%), and none considered equity in relation to “conflict of interest.” Relevant terms used included equality, disparities, and minorities. The handbooks addressed a median of 3 (IQR = 1-4) PROGRESS-PLUS groups per guidance. The majority considered “gender/sex” (61%), “race/ethnicity/culture/language” (58%), “personal characteristics associated with discrimination” (56%), and “place of residence” (55%) in their equity guidance. Few handbooks considered “social capital” (6%) and “features of relationships” (7%).
Conclusion: Approximately half of guideline-producing organizations consider equity in guideline development, with considerations limited to a few groups of populations and a few steps in the guideline development process.
Patient Relevance and Involvement: This review will help organizations reevaluate their guideline development processes and reformulate them to better consider vulnerable populations, thus ensuring integrity in patients’ evaluation and management. There was no public involvement in this review.