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    Rights statement: © 2013 Sinclair et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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World Health Organization guideline development: an evaluation

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World Health Organization guideline development : an evaluation. / Sinclair, David; Isba, Rachel; Kredo, Tamara; Zani, Babalwa; Smith, Helen; Garner, Paul.

In: PLoS ONE, Vol. 8, No. 5, e63715, 31.05.2013.

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Sinclair, D, Isba, R, Kredo, T, Zani, B, Smith, H & Garner, P 2013, 'World Health Organization guideline development: an evaluation', PLoS ONE, vol. 8, no. 5, e63715. https://doi.org/10.1371/journal.pone.0063715

APA

Sinclair, D., Isba, R., Kredo, T., Zani, B., Smith, H., & Garner, P. (2013). World Health Organization guideline development: an evaluation. PLoS ONE, 8(5), [e63715]. https://doi.org/10.1371/journal.pone.0063715

Vancouver

Sinclair D, Isba R, Kredo T, Zani B, Smith H, Garner P. World Health Organization guideline development: an evaluation. PLoS ONE. 2013 May 31;8(5). e63715. https://doi.org/10.1371/journal.pone.0063715

Author

Sinclair, David ; Isba, Rachel ; Kredo, Tamara ; Zani, Babalwa ; Smith, Helen ; Garner, Paul. / World Health Organization guideline development : an evaluation. In: PLoS ONE. 2013 ; Vol. 8, No. 5.

Bibtex

@article{8f03272acb05441a97c238aad0000e4d,
title = "World Health Organization guideline development: an evaluation",
abstract = "BackgroundResearch 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.Methods and FindingsWe 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.ConclusionsSince 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.",
author = "David Sinclair and Rachel Isba and Tamara Kredo and Babalwa Zani and Helen Smith and Paul Garner",
note = " {\textcopyright} 2013 Sinclair et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",
year = "2013",
month = may
day = "31",
doi = "10.1371/journal.pone.0063715",
language = "English",
volume = "8",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",

}

RIS

TY - JOUR

T1 - World Health Organization guideline development

T2 - an evaluation

AU - Sinclair, David

AU - Isba, Rachel

AU - Kredo, Tamara

AU - Zani, Babalwa

AU - Smith, Helen

AU - Garner, Paul

N1 - © 2013 Sinclair et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2013/5/31

Y1 - 2013/5/31

N2 - BackgroundResearch 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.Methods and FindingsWe 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.ConclusionsSince 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.

AB - BackgroundResearch 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.Methods and FindingsWe 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.ConclusionsSince 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.

U2 - 10.1371/journal.pone.0063715

DO - 10.1371/journal.pone.0063715

M3 - Journal article

VL - 8

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 5

M1 - e63715

ER -