GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale

J Clin Epidemiol. 2017 Oct:90:59-67. doi: 10.1016/j.jclinepi.2017.01.014. Epub 2017 Apr 12.


Objectives: This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for development of clinical, public health, and health system guidelines.

Study design and setting: We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve.

Results: We developed three articles on incorporating equity considerations into the overall approach to guideline development, rating certainty, and assembling the evidence base and evidence to decision and/or recommendation.

Conclusion: Clinical and public health guidelines have a role to play in promoting health equity by explicitly considering equity in the process of guideline development.

Keywords: GRADE; Guidelines; Health equity; Socially disadvantaged; Specific populations; Underserved.

MeSH terms

  • Evidence-Based Practice
  • Health Equity*
  • Humans
  • Practice Guidelines as Topic / standards*
  • Research Design
  • Vulnerable Populations*