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Incorporating equity issues into the development of Colombian clinical practice guidelines: suggestions for the GRADE approach.

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Title: Incorporating equity issues into the development of Colombian clinical practice guidelines: suggestions for the GRADE approach.
Alternate Title: Incorporando equidad al desarrollo de guías de práctica clínica colombianas: sugerencias para la aproximación Grade.
Authors: Eslava-Schmalbach, Javier H.1 jheslavas@unal.edu.co, Welch, Vivian A.2 vivian.welch@uottawa.ca, Tugwell, Peter2, Amaya, Ana C.1 acamayaa@unal.edu.co, Gaitán, Hernando1 hggaitand@unal.edu.co, Mosquera, Paola1 paolamosquera@gmail.com, Molina, Felipe1 hfmolinal@unal.edu.co, Peralta, Fernando1 fperaltap@unal.edu.co, Romero-Vanegas, Sara1 sarajromerov@gmail.com, Pardo, Rodrigo1 rpardot@unal.edu.co, Alzate, Juan Pablo1 jpalzateg@unal.edu.co
Source: Revista de Salud Pública. feb2016, Vol. 18 Issue 1, p72-81. 10p.
Subjects: PHYSICIAN practice patterns, MEDICAL quality control, SOCIAL groups, SURVEYS
Abstract (English): Objective To propose how to incorporate equity issues, using the GRADE approach, into the development and implementation of Colombian Clinical Practice Guidelines. Methodology This proposal was developed in four phases: 1. Included a literature review and the development of a preliminary proposal about how to include equity issues; 2. Involved an informal discussion to reach a consensus on improving the first proposal; 3. Was a survey of the researchers' acceptance levels of the proposal, and; 4. A final informal consensus was formed to adjust the proposal. Results A proposal on how to incorporate equity issues into the GRADE approach was developed. It places particular emphasis on the recognition of disadvantaged populations in the development and implementation of the suggested guideline. PROGRESS-Plus is recommended for use in exploring the various categories of disadvantaged people. The proposal suggests that evidence be rated differentially by giving higher ratings to studies that consider equity issues than those that do not. The proposal also suggests the inclusion of indicators to monitor the impacts of the implementation of CPGs on disadvantaged people. Conclusions A consideration of equity in the development and implementation of clinical practice guidelines and quality assessments of the evidence would achieve more in the participation of potential actors in the process and reflect on the effectiveness of the proposed interventions across all social groups. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivo Proponer como incorporar temas de equidad en el desarrollo e implementación de guías de práctica clínica colombianas utilizando el acercamiento GRADE. Metodología Esta propuesta fue desarrollada en 4 fases: una revisión de la literatura y desarrollo de una propuesta preliminar sobre como incluir temas de equidad, discusión informal para alcanzar un consenso que mejore la primera propuesta; una encuesta sobre los niveles de aceptación de la propuesta y un consenso informal final para ajustar la propuesta. Resultados Se desarrolló una propuesta sobre como incorporar temas de equidad con el acercamiento GRADE. Este hace énfasis especial en el reconocimiento de poblaciones en desventaja al desarrollar e implementar guías. Se recomienda el uso del PROGRESS-Plus para explorar las categorías de las poblaciones en desventaja. La propuesta sugiere una calificación diferencial de la evidencia dando clasificaciones superiores a los estudios que toman en consideración temas de equidad. Esta propuesta también sugiere la inclusión de indicadores que monitoreen el impacto de la implementación de GPC en personas en desventaja. Conclusiones Tener en cuenta la equidad en el desarrollo e implementación de las guías de práctica clínica y la evaluación de calidad de la evidencia puede lograr más en la participación de los actores potenciales del proceso y reflejarse en la efectividad de las intervenciones propuestas en todos los grupos sociales. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Objective To propose how to incorporate equity issues, using the GRADE approach, into the development and implementation of Colombian Clinical Practice Guidelines. Methodology This proposal was developed in four phases: 1. Included a literature review and the development of a preliminary proposal about how to include equity issues; 2. Involved an informal discussion to reach a consensus on improving the first proposal; 3. Was a survey of the researchers' acceptance levels of the proposal, and; 4. A final informal consensus was formed to adjust the proposal. Results A proposal on how to incorporate equity issues into the GRADE approach was developed. It places particular emphasis on the recognition of disadvantaged populations in the development and implementation of the suggested guideline. PROGRESS-Plus is recommended for use in exploring the various categories of disadvantaged people. The proposal suggests that evidence be rated differentially by giving higher ratings to studies that consider equity issues than those that do not. The proposal also suggests the inclusion of indicators to monitor the impacts of the implementation of CPGs on disadvantaged people. Conclusions A consideration of equity in the development and implementation of clinical practice guidelines and quality assessments of the evidence would achieve more in the participation of potential actors in the process and reflect on the effectiveness of the proposed interventions across all social groups. [ABSTRACT FROM AUTHOR]
ISSN:01240064
DOI:10.15446/rsap.v18n1.45002