Oxman Andrew D, Schünemann Holger J, Fretheim Atle
Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
Health Res Policy Syst. 2006 Dec 8;4:26. doi: 10.1186/1478-4505-4-26.
The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 14th of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this.
We reviewed the literature on reporting guidelines and recommendations.
We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.
There is little empirical evidence that addresses these questions. Our answers are based on logical arguments and standards put forward by other groups. What standard types of recommendations or reports should WHO use? WHO should develop standard formats for reporting recommendations to facilitate recognition and use by decision makers for whom the recommendations are intended, and to ensure that all the information needed to judge the quality of a guideline, determine its applicability and, if needed, adapt it, is reported. WHO should develop standard formats for full systematically developed guidelines that are sponsored by WHO, rapid assessments, and guidelines that are endorsed by WHO. All three formats should include the same information as full guidelines, indicating explicitly what the group preparing the guideline did not do, as well as the methods that were used. These formats should be used across clinical, public health and health systems recommendations. How should recommendations be formulated and reported? Reports should be structured, using headings that correspond to those suggested by the Conference on Guideline Standardization or similar headings. The quality of evidence and strength of recommendations should be reported explicitly using a standard approach. The way in which recommendations are formulated should be adapted to the specific characteristics of a specific guideline. Urgent attention should be given to developing a template that provides decision makers with the relevant global evidence that is needed to inform a decision and offers practical methods for incorporating the context specific evidence and judgements that are needed.
世界卫生组织（WHO）与世界上许多其他组织一样，认识到需要采用更严格的流程，以确保医疗保健建议以现有最佳研究证据为依据。这是为世界卫生组织健康研究咨询委员会向WHO提供关于如何实现这一目标的建议而编写的16篇综述系列中的第14篇。
我们回顾了关于报告指南和建议的文献。
我们在PubMed和三个方法学研究数据库中搜索了现有的系统评价和相关的方法学研究。我们自己没有进行系统评价。我们的结论基于现有证据、对WHO和其他组织正在开展工作的考虑以及逻辑论证。
几乎没有实证证据能解决这些问题。我们的答案基于逻辑论证以及其他团体提出的标准。WHO应使用哪些标准类型的建议或报告？WHO应制定报告建议的标准格式，以便于决策者识别和使用这些建议，并确保报告判断指南质量、确定其适用性以及在必要时进行调整所需的所有信息。WHO应为WHO发起的全面系统制定的指南、快速评估以及WHO认可的指南制定标准格式。所有这三种格式都应包含与完整指南相同的信息，明确指出编写指南的小组未开展的工作以及所使用的方法。这些格式应适用于临床、公共卫生和卫生系统方面的建议。建议应如何制定和报告？报告应采用结构化形式，使用与指南标准化会议建议的标题或类似标题相对应的标题。应使用标准方法明确报告证据质量和建议强度。建议的制定方式应根据特定指南的具体特点进行调整。应立即关注制定一个模板，为决策者提供做出决策所需的相关全球证据，并提供纳入特定背景证据和判断所需的实用方法。
