World Health Organization guideline development: an evaluation.

<h4>Background</h4>Research in 2007 showed that World Health Organization (WHO) recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO...

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Autores principales:	David Sinclair, Rachel Isba, Tamara Kredo, Babalwa Zani, Helen Smith, Paul Garner
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c393afe33909478f956108938766752b
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spelling	oai:doaj.org-article:c393afe33909478f956108938766752b2021-11-18T07:43:42ZWorld Health Organization guideline development: an evaluation.1932-620310.1371/journal.pone.0063715https://doaj.org/article/c393afe33909478f956108938766752b2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23741299/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Research in 2007 showed that World Health Organization (WHO) recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO established a "Guidelines Review Committee" (GRC) to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff's perceptions of the new procedures.<h4>Methods and findings</h4>We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for "Rigour of Development" (up 37.6%, from 30.7% to 68.3%) and "Editorial Independence" (up 52.7%, from 20.9% to 73.6%). Four main themes emerged from the interviews: (1) high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2) views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3) staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4) the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support.<h4>Conclusions</h4>Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance standards they have set, are fully embedded within the organization.David SinclairRachel IsbaTamara KredoBabalwa ZaniHelen SmithPaul GarnerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 5, p e63715 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David Sinclair Rachel Isba Tamara Kredo Babalwa Zani Helen Smith Paul Garner World Health Organization guideline development: an evaluation.
description	<h4>Background</h4>Research in 2007 showed that World Health Organization (WHO) recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own "Guidelines for Guidelines". In response, the WHO established a "Guidelines Review Committee" (GRC) to implement and oversee internationally recognized standards. We examined the impact of these changes on WHO guideline documents and explored senior staff's perceptions of the new procedures.<h4>Methods and findings</h4>We used the AGREE II guideline appraisal tool to appraise ten GRC-approved guidelines from nine WHO departments, and ten pre-GRC guidelines matched by department and topic. We interviewed 20 senior staff across 16 departments and analyzed the transcripts using the framework approach. Average AGREE II scores for GRC-approved guidelines were higher across all six AGREE domains compared with pre-GRC guidelines. The biggest changes were noted for "Rigour of Development" (up 37.6%, from 30.7% to 68.3%) and "Editorial Independence" (up 52.7%, from 20.9% to 73.6%). Four main themes emerged from the interviews: (1) high standards were widely recognized as essential for WHO credibility, particularly with regard to conflicts of interest; (2) views were mixed on whether WHO needed a single quality assurance mechanism, with some departments purposefully bypassing the procedures; (3) staff expressed some uncertainties in applying the GRADE approach, with departmental staff concentrating on technicalities while the GRC remained concerned the underlying principles were not fully institutionalized; (4) the capacity to implement the new standards varied widely, with many departments looking to an overstretched GRC for technical support.<h4>Conclusions</h4>Since 2007, WHO guideline development methods have become more systematic and transparent. However, some departments are bypassing the procedures, and as yet neither the GRC, nor the quality assurance standards they have set, are fully embedded within the organization.
format	article
author	David Sinclair Rachel Isba Tamara Kredo Babalwa Zani Helen Smith Paul Garner
author_facet	David Sinclair Rachel Isba Tamara Kredo Babalwa Zani Helen Smith Paul Garner
author_sort	David Sinclair
title	World Health Organization guideline development: an evaluation.
title_short	World Health Organization guideline development: an evaluation.
title_full	World Health Organization guideline development: an evaluation.
title_fullStr	World Health Organization guideline development: an evaluation.
title_full_unstemmed	World Health Organization guideline development: an evaluation.
title_sort	world health organization guideline development: an evaluation.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/c393afe33909478f956108938766752b
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World Health Organization guideline development: an evaluation.

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