Akl EA, Welch V, Pottie K, Eslava-Schmalbach J, Darzi A, Sola I, Katikireddi SV, Singh J, Murad MH, Meerpohl J, et al. GRADE Equity Guidelines 2: Considering health equity in the GRADE guideline development process. J.Clin.Epidemiol. Epub 2017 May 9. PMID: 28499847.

OBJECTIVE:
to provide guidance for guideline developers on how to consider health equity at key stages of the guideline development process.
STUDY DESIGN AND SETTING:
literature review followed by group discussions and consensus building.
RESULTS:
The key stages at which guideline developers could consider equity include setting priorities, guideline group membership, identifying the target audience(s), generating the guideline questions, considering the importance of outcomes and interventions, deciding what evidence to include and searching for evidence, summarising the evidence and considering additional information, wording of recommendations, and evaluation and use. We provide examples of how guidelines have actually considered equity at each of these stages.
CONCLUSION:
Guideline projects should consider the above suggestions for recommendations that are equity-sensitive.
Copyright © 2017 Elsevier Inc. All rights reserved.

DOI: https://doi.org/10.1016/j.jclinepi.2017.01.017.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28499847.

Grimberg A, Allen DB. Growth hormone treatment for growth hormone deficiency and idiopathic short stature: new guidelines shaped by the presence and absence of evidence. Curr.Opin.Pediatr. Epub 2017 May 18. PMID: 28525404.

PURPOSE OF REVIEW:
The Pediatric Endocrine Society recently published new guidelines for the use of human growth hormone (hGH) and human insulin-like growth factor-I (hIGF-I) treatment for growth hormone deficiency, idiopathic short stature, and primary IGF-I deficiency in children and adolescents. This review places the new guidelines in historical contexts of the life cycle of hGH and the evolution of US health care, and highlights their future implications.
RECENT FINDINGS:
The new hGH guidelines, the first to be created by the Grading of Recommendations Assessment, Development and Evaluation approach, are more conservative than their predecessors. They follow an extended period of hGH therapeutic expansion at a time when US health care is pivoting toward value-based practice. There are strong supporting evidence and general agreement regarding the restoration of hormonal normalcy in children with severe deficiency of growth hormone or hIGF-I. More complex are issues related to hGH treatment to increase growth rates and heights of otherwise healthy short children with either idiopathic short stature or 'partial' isolated idiopathic growth hormone deficiency.
SUMMARY:
The guidelines-developing process revealed fundamental questions about hGH treatment that still need evidence-based answers. Unless and until such research is performed, a more restrained hGH-prescribing approach is appropriate.

DOI: http://dx.doi.org/10.1097/MOP.0000000000000505.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=28525404.

Mas MA. Capsule Commentary on Bennett et al., Engaging Stakeholders to Inform Clinical Practice Guidelines that Address Multiple Chronic Conditions. J.Gen.Intern.Med. Epub 2017 May 17. PMID: 28516325.
Comment on:

Bennett WL, Robbins CW, Bayliss EA, Wilson R, Tabano H, Mularski RA, Chan WV, Puhan M, Yu T, Leff B, Li T, Dickersin K, Glover C, Maslow K, Armacost K, Mintz S, Boyd CM. Engaging Stakeholders to Inform Clinical Practice Guidelines That Address Multiple Chronic Conditions. J Gen Intern Med. 2017 Mar 27. doi: 10.1007/s11606-017-4039-5. [Epub ahead of print] PubMed PMID: 28349409.

DOI: http://dx.doi.org/10.1007/s11606-017-4080-4.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=28516325.

Baldassari CM. Do Clinical Practice Guidelines Improve Quality? Otolaryngol.Head Neck Surg. Epub 2017 Apr 1. PMID: 28419813.

Controversy exists surrounding how to best define and assess quality in the health care setting. Clinical practice guidelines (CPGs) have been developed to improve the quality of medical care by highlighting key clinical recommendations based on recent evidence. However, data linking CPGs to improvements in outcomes in otolaryngology are lacking. Numerous barriers contribute to difficulties in translating CPGs to improvements in quality. Future initiatives are needed to improve CPG adherence and define the impact of CPG recommendations on the quality of otolaryngologic care provided to our patients.

DOI: http://dx.doi.org/10.1177/0194599817703950.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28419813.

Awad IA. 'Standards and guidelines for standards and guidelines': intracranial dural arteriovenous shunts as a paradigm. J.Neurointerv Surg. 2017 May;9(5):429-30. PMID: 26790827.

[First paragraph]

Seon-Kyu Lee and a formidable panel of authors undertook the laudable task of writing standards and guidelines for the management of an often poorly understood neurovascular entity which they chose to describe as intracranial ‘dural arteriovenous shunts’ (DAVS). I start and end this editorial by commending them on a clear, well-balanced, and concise review. The conclusions and recommendations are sensible, pragmatic and should be widely accepted and applied.

Comment on:

Lee SK, Hetts SW, Halbach V, terBrugge K, Ansari SA, Albani B, Abruzzo T, Arthur A, Alexander MJ, Albuquerque FC, Baxter B, Bulsara KR, Chen M, Delgado Almandoz JE, Fraser JF, Frei D, Gandhi CD, Heck D, Hussain MS, Kelly M, Klucznik R, Leslie-Mazwi T, McTaggart RA, Meyers PM, Patsalides A, Prestigiacomo C, Pride GL, Starke R, Sunenshine P, Rasmussen P, Jayaraman MV; Standard and Guidelines Committee for the Society of Neurointerventional Surgery.. Standard and Guidelines: Intracranial Dural Arteriovenous Shunts. J Neurointerv Surg. 2017 May;9(5):516-523. doi: 10.1136/neurintsurg-2015-012116. Epub 2015 Nov 27. PubMed PMID: 26614491.

DOI: http://dx.doi.org/10.1136/neurintsurg-2016-012264.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=26790827.

Cerfolio RJ. Debunking dogma: The arduous task of writing AATS consensus guidelines. J.Thorac.Cardiovasc.Surg. 2017 Jun;153(6):e147. PMID: 28283235.
Comment on:

Shen KR, Bribriesco A, Crabtree T, Denlinger C, Eby J, Eiken P, Jones DR, Keshavjee S, Maldonado F, Paul S, Kozower B. The American Association for Thoracic Surgery consensus guidelines for the management of empyema. J Thorac Cardiovasc Surg. 2017 Jun;153(6):e129-e146. doi: 10.1016/j.jtcvs.2017.01.030. Epub 2017 Feb 4. PubMed PMID: 28274565.

DOI: http:/dx.doi.org/10.1016/j.jtcvs.2017.02.007.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=28283235.

Choy KW, Choy KH. An appeal to the medical community: the need for laboratory specialist input in the development of clinical practice guidelines. Intern.Med.J. 2017 Apr;47(4):472-3. PMID: 28401715.
DOI: http://dx.doi.org/10.1111/imj.13383.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=28401715.

DeCampli WM. Guidelines should bother us, not comfort us. J.Thorac.Cardiovasc.Surg. 2017 Jun;153(6):1458-61. PMID: 27726876.
Comment on:

Brothers JA, Frommelt MA, Jaquiss RDB, Myerburg RJ, Fraser CD Jr, Tweddell JS. Expert consensus guidelines: Anomalous aortic origin of a coronary artery. J Thorac Cardiovasc Surg. 2017 Jun;153(6):1440-1457. doi: 10.1016/j.jtcvs.2016.06.066. Epub 2017 Feb 4. PubMed PMID: 28274557.

DOI: http://dx.doi.org/10.1016/j.jtcvs.2016.09.008.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=27726876.

Fernández Mondéjar E. Considerations on the low adherence to clinical practice guidelines | Consideraciones sobre la baja adherencia a las guías de práctica clínica. Med.Intensiva. 2017 Jun-Jul;41(5):265-6. PMID: 28499614.

[Article in English, Spanish]

DOI: http://dx.doi.org/10.1016/j.medin.2017.04.001.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28499614.

Kels CG, Kels LH. Legal Ramifications of Ambiguous Clinical Guidelines. JAMA. 2017 May 16;317(19):2020. PMID: 28510673.
Comment on:

Klasco RS, Glinert LH. Language for Actionable Recommendations in Clinical Guidelines: Avoiding Hedging and Equivocation. JAMA. 2017 Feb 14;317(6):583-584. doi: 10.1001/jama.2016.20670. PubMed PMID: 28196262.

DOI: http://dx.doi.org/10.1001/jama.2017.4501.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28510673.

Zhang Y, Coello PA, Bro?ek J, Wiercioch W, Etxeandia-Ikobaltzeta I, Akl EA, Meerpohl JJ, Alhazzani W, Carrasco-Labra A, Morgan RL, et al. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health.Qual.Life.Outcomes. 2017 May 2;15(1):52. PMID: 28460638.

BACKGROUND:
There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development.
METHODS:
In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives.
RESULTS:
We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences.
CONCLUSIONS:
Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings.

FREE FULL TEXT: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412036/pdf/12955_2017_Article_621.pdf
DOI: http://dx.doi.org/10.1186/s12955-017-0621-0.
PubMed: https://www.ncbi.nlm.nih.gov/pubmed/?term=28460638.
PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412036.