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将健康公平考量纳入实践指南工作的七条原则。

Seven principles for integrating health equity considerations in the practice guideline enterprise.

作者信息

Dewidar Omar, Darzi Andrea J, Sayfi Shahab, Pardo Jordi Pardo, Welch Vivian, Wright Grace C, Akl Elie A, Khabsa Joanne, Lin Jennifer S, Morgan Rebecca L, Pottie Kevin, Tufte Janice, Khawandi Jana, Wang Xiaoqin, Oloyede Oyekola, Lotfi Tamara, Yao Xiaomei, Pereira Nunes Pinto Ana Carolina, Chi Yuan, Mustafa Reem A, Schünemann Holger J, Tugwell Peter

机构信息

Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Bruyère Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Clin Epidemiol. 2025 Mar 26;182:111777. doi: 10.1016/j.jclinepi.2025.111777.

Abstract

BACKGROUND AND OBJECTIVES

Health equity aims to provide all individuals with equal and fair opportunities to achieve optimal health. Practice guidelines can play a pivotal role in advancing health equity; yet, few organizations use tools to systematically integrate health equity considerations. Thus, it is important to establish a foundation for practical tools to support the systematic integration of health equity considerations. This manuscript proposes principles for the integration of health equity considerations in the practice guideline enterprise.

METHODS

In the process of developing an equity extension for the GIN-McMaster guideline development checklist, we established a diverse advisory group of guideline developers, patients, members of the public experiencing inequities, health equity researchers, and guideline developers. We formulated the principles informed by a methodological review of guideline handbooks and iterative discussions between working group members.

RESULTS

We identified the following seven principles for integrating health equity considerations into the practice guideline enterprise: (1) articulating health equity, (2) a priori planning for considering health equity, (3) selection and engagement of individuals with lived experiences of inequities, (4) equity in evidence synthesis, (5) developing equity-informed recommendations, (6) inclusive knowledge mobilization, and (7) evaluating the impact of health equity considerations. We elaborated on the importance of the principles using published examples and mapped them to the different phases of the guideline development process.

CONCLUSION

Guideline developers should adhere to these principles in the development of guidelines and health equity guideline development and appraisal tools. These principles are the foundational concepts for developing health equity extension items for the GIN-McMaster guideline development checklist.

摘要

背景与目标

健康公平旨在为所有人提供平等且公平的机会,以实现最佳健康状态。实践指南在促进健康公平方面可发挥关键作用;然而,很少有组织使用工具来系统地纳入健康公平考量。因此,为支持健康公平考量的系统整合建立实用工具的基础很重要。本文提出了在实践指南制定过程中整合健康公平考量的原则。

方法

在为全球实践指南网络-麦克马斯特大学指南制定清单开发公平性扩展内容的过程中,我们成立了一个由指南制定者、患者、经历过不公平现象的公众成员、健康公平研究人员和指南制定者组成的多元化咨询小组。我们通过对指南手册的方法学回顾以及工作组成员之间的反复讨论,制定了这些原则。

结果

我们确定了将健康公平考量纳入实践指南制定过程的以下七条原则:(1)阐明健康公平,(2)对健康公平考量进行预先规划,(3)选择有不公平经历的个人并让其参与,(4)证据综合中的公平性,(5)制定基于公平性的建议,(6)包容性知识传播,(7)评估健康公平考量的影响。我们用已发表的实例阐述了这些原则的重要性,并将它们映射到指南制定过程的不同阶段。

结论

指南制定者在制定指南以及健康公平指南制定和评估工具时应遵循这些原则。这些原则是为全球实践指南网络-麦克马斯特大学指南制定清单开发健康公平扩展项目的基础概念。

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