Skip to main content
Top
Published in: Health Research Policy and Systems 1/2006

Open Access 01-12-2006 | Review

Improving the use of research evidence in guideline development: 14. Reporting guidelines

Authors: Andrew D Oxman, Holger J Schünemann, Atle Fretheim

Published in: Health Research Policy and Systems | Issue 1/2006

Login to get access

Abstract

Background

The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 14th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.

Objectives

We reviewed the literature on reporting guidelines and recommendations.

Methods

We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.

Key questions and answers

There is little empirical evidence that addresses these questions. Our answers are based on logical arguments and standards put forward by other groups.
What standard types of recommendations or reports should WHO use?
  • WHO should develop standard formats for reporting recommendations to facilitate recognition and use by decision makers for whom the recommendations are intended, and to ensure that all the information needed to judge the quality of a guideline, determine its applicability and, if needed, adapt it, is reported.
  • WHO should develop standard formats for full systematically developed guidelines that are sponsored by WHO, rapid assessments, and guidelines that are endorsed by WHO.
  • All three formats should include the same information as full guidelines, indicating explicitly what the group preparing the guideline did not do, as well as the methods that were used.
  • These formats should be used across clinical, public health and health systems recommendations.
How should recommendations be formulated and reported?
  • Reports should be structured, using headings that correspond to those suggested by the Conference on Guideline Standardization or similar headings.
  • The quality of evidence and strength of recommendations should be reported explicitly using a standard approach.
  • The way in which recommendations are formulated should be adapted to the specific characteristics of a specific guideline.
  • Urgent attention should be given to developing a template that provides decision makers with the relevant global evidence that is needed to inform a decision and offers practical methods for incorporating the context specific evidence and judgements that are needed.
Literature
1.
go back to reference Global Programme on Evidence for Health Policy: Guidelines for WHO Guidelines. Geneva: World Health Organisation, 2003 (EIP/GPE/EQC/2003.1) Global Programme on Evidence for Health Policy: Guidelines for WHO Guidelines. Geneva: World Health Organisation, 2003 (EIP/GPE/EQC/2003.1)
2.
go back to reference Panisett U: A review of WHO recommendations published in 2005. Panisett U: A review of WHO recommendations published in 2005.
3.
go back to reference Guyatt G, Yayward R, Richardson WS, Green L, Wilson M, Sinclair J: Moving from evidence to action. Users' Guides to the Medical Literature. Edited by: Guyatt G, Rennie D. 2002, Chicago: AMA Press, 175-99. Guyatt G, Yayward R, Richardson WS, Green L, Wilson M, Sinclair J: Moving from evidence to action. Users' Guides to the Medical Literature. Edited by: Guyatt G, Rennie D. 2002, Chicago: AMA Press, 175-99.
4.
go back to reference Institute of Medicine: Guidelines for Clinical Practice: From Development to Use. 1992, Washington, DC: National Academy Pr Institute of Medicine: Guidelines for Clinical Practice: From Development to Use. 1992, Washington, DC: National Academy Pr
5.
go back to reference Shaneyfelt TM, Mayo-Smith MF, Rothwangl J: Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer reviewed medical literature. JAMA. 1999, 281: 1900-5. 10.1001/jama.281.20.1900.CrossRefPubMed Shaneyfelt TM, Mayo-Smith MF, Rothwangl J: Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer reviewed medical literature. JAMA. 1999, 281: 1900-5. 10.1001/jama.281.20.1900.CrossRefPubMed
6.
go back to reference The AGREE Collaboration: Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care. 2003, 12: 18-23. 10.1136/qhc.12.1.18.CrossRef The AGREE Collaboration: Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care. 2003, 12: 18-23. 10.1136/qhc.12.1.18.CrossRef
7.
go back to reference Shiffman RN, Shekelle P, Overhage JM, Slutsky J, Grimshaw J, Deshpande AM: Standardized Reporting of Clinical Practice Guidelines: A Proposal from the Conference on Guideline Standardization. Ann Intern Med. 2003, 139: 493-8.CrossRefPubMed Shiffman RN, Shekelle P, Overhage JM, Slutsky J, Grimshaw J, Deshpande AM: Standardized Reporting of Clinical Practice Guidelines: A Proposal from the Conference on Guideline Standardization. Ann Intern Med. 2003, 139: 493-8.CrossRefPubMed
8.
go back to reference Grilli R, Magrini N, Penna A, Mura G, Liberati A: Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet. 2000, 355: 103-6. 10.1016/S0140-6736(99)02171-6.CrossRefPubMed Grilli R, Magrini N, Penna A, Mura G, Liberati A: Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet. 2000, 355: 103-6. 10.1016/S0140-6736(99)02171-6.CrossRefPubMed
9.
go back to reference Oxman AD, Schünemann HJ, Fretheim A: Improving the Use of Research Evidence in Guideline Development: 8. Synthesis and presentation of evidence. Health Res Policy Syst. 2006 Oxman AD, Schünemann HJ, Fretheim A: Improving the Use of Research Evidence in Guideline Development: 8. Synthesis and presentation of evidence. Health Res Policy Syst. 2006
10.
go back to reference Fretheim A, Schünemann HJ, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 15. Disseminating and implementing guidelines. Health Res Policy Syst. 2006 Fretheim A, Schünemann HJ, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 15. Disseminating and implementing guidelines. Health Res Policy Syst. 2006
11.
go back to reference Oxman AD, Fretheim A, Schünemann HJ: A review of WHO documents that guide the development, dissemination and implementation of recommendations by WHO. Oxman AD, Fretheim A, Schünemann HJ: A review of WHO documents that guide the development, dissemination and implementation of recommendations by WHO.
12.
go back to reference Moynihan R, Oxman AD, Lavis JN, Paulsen E: Evidence-Informed Health Policy: Using Research to Make Health Systems Healthier. A review of organizations that support the use of research evidence in developing guidelines, technology assessments, and health policy, for the WHO Advisory Committee on Health Research. 2006, Oslo: Norwegian Knowledge Centre for the Health Services Moynihan R, Oxman AD, Lavis JN, Paulsen E: Evidence-Informed Health Policy: Using Research to Make Health Systems Healthier. A review of organizations that support the use of research evidence in developing guidelines, technology assessments, and health policy, for the WHO Advisory Committee on Health Research. 2006, Oslo: Norwegian Knowledge Centre for the Health Services
15.
go back to reference Oxman AD, Schünemann HJ, Fretheim A: Improving the use of research evidence in guideline development: introduction. Health Res Policy Syst. 2006 Oxman AD, Schünemann HJ, Fretheim A: Improving the use of research evidence in guideline development: introduction. Health Res Policy Syst. 2006
19.
go back to reference Raine R, Sanderson C, Black N: Developing clinical practice guidelines: a challenge to current methods. BMJ. 2005, 331: 631-3. 10.1136/bmj.331.7517.631.CrossRefPubMedPubMedCentral Raine R, Sanderson C, Black N: Developing clinical practice guidelines: a challenge to current methods. BMJ. 2005, 331: 631-3. 10.1136/bmj.331.7517.631.CrossRefPubMedPubMedCentral
20.
go back to reference Briss PA, Zaza S, Pappaioanou M: Developing an evidence-based guide to community preventive services-methods. Am J Prev Med. 2000, 18 (1S): 35-43. 10.1016/S0749-3797(99)00119-1.CrossRefPubMed Briss PA, Zaza S, Pappaioanou M: Developing an evidence-based guide to community preventive services-methods. Am J Prev Med. 2000, 18 (1S): 35-43. 10.1016/S0749-3797(99)00119-1.CrossRefPubMed
21.
go back to reference Stevens A, Colin-Jones D, Gabbay J: 'Quick and clean': authoritative health technology assessment for local health care contracting. Health Trends. 1995, 27: 37-42.PubMed Stevens A, Colin-Jones D, Gabbay J: 'Quick and clean': authoritative health technology assessment for local health care contracting. Health Trends. 1995, 27: 37-42.PubMed
22.
go back to reference Hailey D, COrabian P, Harstall C, Schneider W: The use and impact of rapid health technology assessments. Int J Technol Assess Health Care. 2000, 16: 651-6. 10.1017/S0266462300101205.CrossRefPubMed Hailey D, COrabian P, Harstall C, Schneider W: The use and impact of rapid health technology assessments. Int J Technol Assess Health Care. 2000, 16: 651-6. 10.1017/S0266462300101205.CrossRefPubMed
23.
go back to reference Perleth M, Luhmann D, Givis B, Droste S: Rapid Assessments – quick evaluation of medical technology. Gesundheitswesen. 2001, 63 (Suppl 1): S79-84. 10.1055/s-2001-12121.CrossRefPubMed Perleth M, Luhmann D, Givis B, Droste S: Rapid Assessments – quick evaluation of medical technology. Gesundheitswesen. 2001, 63 (Suppl 1): S79-84. 10.1055/s-2001-12121.CrossRefPubMed
24.
go back to reference Canadian Coordinating Office for Health Technoloty Assessment: Rapid response services in health technology assessment: information from INAHTA members and additional information. 2004, Ottawa: CCOHTA Canadian Coordinating Office for Health Technoloty Assessment: Rapid response services in health technology assessment: information from INAHTA members and additional information. 2004, Ottawa: CCOHTA
25.
go back to reference Milne R, Clegg A, Stevens A: HTA responses and the classic HTA report. J Public Health Med. 2003, 25: 102-6. 10.1093/pubmed/fdg023.CrossRefPubMed Milne R, Clegg A, Stevens A: HTA responses and the classic HTA report. J Public Health Med. 2003, 25: 102-6. 10.1093/pubmed/fdg023.CrossRefPubMed
26.
go back to reference Schünemann H, Fretheim A, Oxman AD: Adaptation, applicability, transferability. Schünemann H, Fretheim A, Oxman AD: Adaptation, applicability, transferability.
27.
go back to reference Graham ID, Harrison MB, Brouwers M, Davies BL, Dunn S: Facilitating the use of evidence in practice: evaluating and adapting clinical practice guidelines for local use by health care organizations. J Obstet Gynecol Neonatal Nurs. 2002, 31: 599-611. 10.1111/j.1552-6909.2002.tb00086.x.CrossRefPubMed Graham ID, Harrison MB, Brouwers M, Davies BL, Dunn S: Facilitating the use of evidence in practice: evaluating and adapting clinical practice guidelines for local use by health care organizations. J Obstet Gynecol Neonatal Nurs. 2002, 31: 599-611. 10.1111/j.1552-6909.2002.tb00086.x.CrossRefPubMed
28.
go back to reference Graham ID, Harrison MB, Lorimer K, Piercianowski T, Friedberg E, Buchanan M, Harris C: Adapting national and international leg ulcer practice guidelines for local use: the Ontario Leg Ulcer Community Care Protocol. Adv Skin Wound Care. 2005, 18: 307-18. 10.1097/00129334-200507000-00011.CrossRefPubMed Graham ID, Harrison MB, Lorimer K, Piercianowski T, Friedberg E, Buchanan M, Harris C: Adapting national and international leg ulcer practice guidelines for local use: the Ontario Leg Ulcer Community Care Protocol. Adv Skin Wound Care. 2005, 18: 307-18. 10.1097/00129334-200507000-00011.CrossRefPubMed
30.
go back to reference Gyorkos TW, Tannenbaum TN, Abrahamowicz M, Oxman AD, Scott EAF, Millson ME: An approach to the development of practice guidelines for community health interventions. Can J Public Health. 1994, 85 (Suppl 1): S8-13.PubMed Gyorkos TW, Tannenbaum TN, Abrahamowicz M, Oxman AD, Scott EAF, Millson ME: An approach to the development of practice guidelines for community health interventions. Can J Public Health. 1994, 85 (Suppl 1): S8-13.PubMed
31.
go back to reference Lavis JN, Davies HTO, Oxman AD, Denis JL, Golden-Biddle K, Ferlie E: Towards systematic reviews that inform healthcare management and policymaking. Journal of Health Services Research and Policy. 2005, 10 (Suppl 1): 35-48. 10.1258/1355819054308549.CrossRefPubMed Lavis JN, Davies HTO, Oxman AD, Denis JL, Golden-Biddle K, Ferlie E: Towards systematic reviews that inform healthcare management and policymaking. Journal of Health Services Research and Policy. 2005, 10 (Suppl 1): 35-48. 10.1258/1355819054308549.CrossRefPubMed
32.
go back to reference Schünemann HJ, Fretheim A, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 1. Guidelines for guidelines. Health Res Policy Syst. 2006 Schünemann HJ, Fretheim A, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 1. Guidelines for guidelines. Health Res Policy Syst. 2006
33.
go back to reference Graham ID, Calder LA, Hebert PC, Carter AO, Tetroe JM: A comparison of clinical practice guideline appraisal instruments. Int J Technol Assess Health Care. 2000, 16: 1024-38. 10.1017/S0266462300103095.CrossRefPubMed Graham ID, Calder LA, Hebert PC, Carter AO, Tetroe JM: A comparison of clinical practice guideline appraisal instruments. Int J Technol Assess Health Care. 2000, 16: 1024-38. 10.1017/S0266462300103095.CrossRefPubMed
34.
go back to reference Hayward RS, Wilson MC, Tunis SR, Bass EB, Rubin HR, Haynes RB: More informative abstracts of articles describing clinical practice guidelines. Ann Intern Med. 1993, 118: 731-7.CrossRefPubMed Hayward RS, Wilson MC, Tunis SR, Bass EB, Rubin HR, Haynes RB: More informative abstracts of articles describing clinical practice guidelines. Ann Intern Med. 1993, 118: 731-7.CrossRefPubMed
35.
go back to reference Schünemann HJ, Fretheim A, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 9. Grading evidence and recommendations. Health Res Policy Syst. 2006 Schünemann HJ, Fretheim A, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 9. Grading evidence and recommendations. Health Res Policy Syst. 2006
36.
go back to reference Shekelle PG, Kravitz RL, Beart J, Marger M, Wang M, Lee M: Are nonspecific practice guidelines potentially harmful? A randomized comparison of the effect of nonspecific versus specific guidelines on physician decision making. Health Serv Res. 2000, 34: 1429-48.PubMedPubMedCentral Shekelle PG, Kravitz RL, Beart J, Marger M, Wang M, Lee M: Are nonspecific practice guidelines potentially harmful? A randomized comparison of the effect of nonspecific versus specific guidelines on physician decision making. Health Serv Res. 2000, 34: 1429-48.PubMedPubMedCentral
40.
go back to reference Oxman AD, Fretheim A, Schünemann HJ: Improving the Use of Research Evidence in Guideline Development: 7. Deciding what evidence to include. Health Res Policy Syst. 2006 Oxman AD, Fretheim A, Schünemann HJ: Improving the Use of Research Evidence in Guideline Development: 7. Deciding what evidence to include. Health Res Policy Syst. 2006
41.
go back to reference Schünemann HJ, Fretheim A, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 13. Adaptation, applicability and transferability. Health Res Policy Syst. 2006 Schünemann HJ, Fretheim A, Oxman AD: Improving the Use of Research Evidence in Guideline Development: 13. Adaptation, applicability and transferability. Health Res Policy Syst. 2006
Metadata
Title
Improving the use of research evidence in guideline development: 14. Reporting guidelines
Authors
Andrew D Oxman
Holger J Schünemann
Atle Fretheim
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Health Research Policy and Systems / Issue 1/2006
Electronic ISSN: 1478-4505
DOI
https://doi.org/10.1186/1478-4505-4-26

Other articles of this Issue 1/2006

Health Research Policy and Systems 1/2006 Go to the issue