Evidence map›Paper›PMID 28389397›Full record

ArticleJournal of clinical epidemiology2017

GRADE equity guidelines 3: considering health equity in GRADE guideline development: rating the certainty of synthesized evidence.

Vivian A Welch, Elie A Akl, Kevin Pottie, Mohammed T Ansari, Matthias Briel, Robin Christensen, Antonio Dans, Leonila Dans, Javier Eslava-Schmalbach, Gordon Guyatt and 23 more

Abstract read
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In one paragraph

Article in Journal of clinical epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Vivian A WelchBruyère Research Institute, University of Ottawa and Bruyère Continuing Care, 85 Primrose Ave, Ottawa K1R 7G5, Canada. Electronic address: vivian.welch@uottawa.ca.
Elie A AklDepartment of Internal Medicine, American University of Beirut, P.O. Box: 11-0236, Riad-El-Solh Beirut, 1107 2020 Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
Kevin PottieBruyère Research Institute, University of Ottawa and Bruyère Continuing Care, 85 Primrose Ave, Ottawa K1R 7G5, Canada; Departments of Family Medicine and Epidemiology and Community Medicine, Bruyère Research Institute, University of Ottawa, WHO and EU ECDC Consultant.
Mohammed T AnsariSchool of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa ON K1G 5Z3 Canada.
Matthias BrielDepartment of Clinical Research, Basel Institute for Clinical Epidemiology and Biostatistics, University of Basel, Spitalstrasse 12, Basel 4031, Switzerland; Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
Robin ChristensenMusculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Antonio DansDepartment of Medicine, University of the Philippines-Manila, Manila 1000, Philippines.
Leonila DansDepartment of Pediatrics, University of the Philippines-Manila, Taft Ave, Manila 1000, Philippines.
Javier Eslava-SchmalbachGroup of Equity in Health, Hospital Universitario Nacional de Colombia, Faculty of Medicine, Universidad Nacional de Colombia; Technology Development Center, Sociedad Colombiana de Anestesiologia y Reanimacion -S.C.A.R.E. Cra 30 45-03, Bogota 111321, Colombia.
Gordon GuyattDepartment of Clinical Epidemiology & Biostatistics and Department of Medicine, McMaster University Health Sciences Centre, McMaster University, 1280 Main Street West, Room HSC-2C12, Hamilton, Ontario L8S 4K1, Canada.
Monica HultcrantzSwedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), S:t Eriksgatan 117, Stockholm SE-102 33, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, Stockholm SE-171 77, Sweden.
Janet JullBruyère Research Institute, University of Ottawa, 85 Primrose Avenue, Room 312, Ottawa, Ontario K1R 7G5.
Srinivasa Vittal KatikireddiMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, UK.
Eddy LangDepartment of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
Elizabeth MatovinovicFaculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Joerg J MeerpohlCochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Strasse 153, Freiburg 79110, Germany; Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité - U1153, Inserm / Université Paris Descartes, Cochrane France, Hôpital Hôtel-Dieu, 1, place du Parvis Notre-Dame, Paris 75004, France.
Rachael L MortonNHMRC Clinical Trials Centre, The University of Sydney, Medical Foundation Building Level 6, 92-94 Parramatta Road, Camperdown, NSW 2050, Australia.
Annhild MosdolKnowledge Centre for the Health Services, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway.
M Hassan MuradMayo Clinic Evidence-Based Practice Center, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
Jennifer PetkovicBruyère Research Institute & University of Ottawa, 85 Primrose Avenue, Ottawa, Ontario K1R 7G5.
Holger SchünemannDepartment of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Ravi SharafDivision of Gastroenterology, Northwell Health/Hofstra University School of Medicine, Long Island Jewish Medical Center, Research Building B202, 270-05 76th Avenue, New Hyde Park, NY 11040, USA.
Bev SheaBruyère Research Institute and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
Jasvinder A SinghMedicine Service, Birmingham Veterans Affairs Medical Center, 700, 19th Street South, Birmingham, AL 35233, USA; Department of Medicine at School of Medicine and the Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, 1720 Second Avenue South, Birmingham, AL 35294-0022, USA; Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905, USA.
Ivan SolàIberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau, CIBER of Epidemiology and Public Health (CIBERESP-IIB Sant Pau), Barcelona, Spain.
Roger StanevInstitute of Technology, University of Washington, 1900 Commerce St., Tacoma, WA 98402, USA.
Airton SteinPublic Health Department - Universidade Federal de Ciencias da Saude de Porto Alegre (Ufcspa), Rua Sarmento Leite, 245, CEP - CEP 90050-170 and HTA of Conceicao Hospital, Porto Alegre, Brazil.
Lehana ThabaneiiDepartment of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Thomy ToniaInstitute of Social and Preventive Medicine, University of Bern, Niesenweg 6, Bern 3012, Switzerland.
Mario TristanIHCAI Foundation & Cochrane Central America & Spanish speaking Caribbean, Av 7. calles 35 y 37, No 35 30, Codigo Postal 10106, San Jose, Costa Rica.
Sigurd VitolsClinical Pharmacology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
Joseph WatineLaboratory Medicine, Hôpital La Chartreuse, avenue Caylet, F-12200, Villefranche-de-Rouergue, France.
Peter TugwellDepartment of Medicine, Faculty of Medicine, University of Ottawa, K1H 8M5, Ottawa, Canada.

Funding

Chief Scientist Office SCAF/15/02Chief Scientist Office SPHSU13Chief Scientist Office SPHSU15Medical Research Council MC_UU_12017/13Medical Research Council MC_UU_12017/15World Health Organization 001
6 · The paper itself

Abstract

objectivesThe aim of this paper is to describe a conceptual framework for how to consider health equity in the Grading Recommendations Assessment and Development Evidence (GRADE) guideline development process. STUDY DESIGN AND

settingConsensus-based guidance developed by the GRADE working group members and other methodologists.

resultsWe developed consensus-based guidance to help address health equity when rating the certainty of synthesized evidence (i.e., quality of evidence). When health inequity is determined to be a concern by stakeholders, we propose five methods for explicitly assessing health equity: (1) include health equity as an outcome; (2) consider patient-important outcomes relevant to health equity; (3) assess differences in the relative effect size of the treatment; (4) assess differences in baseline risk and the differing impacts on absolute effects; and (5) assess indirectness of evidence to disadvantaged populations and/or settings.

conclusionThe most important priority for research on health inequity and guidelines is to identify and document examples where health equity has been considered explicitly in guidelines. Although there is a weak scientific evidence base for assessing health equity, this should not discourage the explicit consideration of how guidelines and recommendations affect the most vulnerable members of society.

Indexed as

Health EquityReview Literature as TopicVulnerable PopulationsEvidence-Based PracticeHumansMeta-Analysis as TopicPractice Guidelines as TopicResearch DesignApplicabilityequityGRADEGuidelinesHealthIndirectnessMeta-analysisSubgroup analysisSystematic review

Identifiers

PMID28389397
PMCPMC5680526

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.