在指南中强化健康公平考量:GIN-麦克马斯特指南制定清单的健康公平扩展版

Enhancing health equity considerations in guidelines: health equity extension of the GIN-McMaster Guideline Development Checklist.

作者信息

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

机构信息

Temerty School of Medicine, University of Toronto, Toronto, Ontario, Canada.

Bruyère Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

EClinicalMedicine. 2025 Mar 28;82:103135. doi: 10.1016/j.eclinm.2025.103135. eCollection 2025 Apr.

Abstract

BACKGROUND

Practice guidelines may reduce health inequities by addressing preventable and unjust differences in health. However, health equity considerations are often inadequately integrated into the guideline planning and development process. This article describes a pragmatic approach to enhancing health equity considerations within guidelines by introducing an extension to the GIN-McMaster Guideline Development Checklist (GDC).

METHODS

We reviewed the latest guidance on enhancing health equity considerations in guideline development to draft the checklist and deployed a global online survey from March 27th, 2024, to May 13th, 2024 to gather consensus. We conducted a methodological review of guideline development handbooks to identify best practices in health equity considerations. An advisory board comprised of diverse interest-holders informed the development of the checklist. We made revisions based on the survey feedback and review findings.

FINDINGS

We present 21 extension items spanning 16 of the 18 guideline development topics from the GIN-McMaster GDC. Key additions include planning for engagement with individuals experiencing inequities in guideline development activities, applying an equity lens, and considering health equity in recommendation formulation, dissemination and implementation strategies. This checklist gives value to lived experiences to enrich health equity assessments, complementing empirical evidence to inform guideline recommendations. Guideline developers should assess guideline sensitivity to health equity to determine resource prioritization for optimal implementation of the extension items.

INTERPRETATION

The GIN-McMaster health equity extension provides guidance for the streamlined integration of health equity considerations throughout the guideline development process. Using this tool alongside the original GIN-McMaster GDC may lead to more equitable and impactful guidelines.

FUNDING

This project was partially funded by Public Health Agency of Canada. The funder was not involved in the conceptualization or design or the conduct of the project.

摘要

背景

实践指南可通过解决可预防的、不公正的健康差异来减少健康不平等。然而,健康公平考量往往未充分纳入指南的规划和制定过程。本文介绍了一种务实的方法,即通过引入对全球循证医学网 - 麦克马斯特指南制定清单(GDC)的扩展,来加强指南中的健康公平考量。

方法

我们回顾了关于在指南制定中加强健康公平考量的最新指南,以起草该清单,并于2024年3月27日至2024年5月13日进行了一项全球在线调查,以达成共识。我们对指南制定手册进行了方法学审查,以确定健康公平考量方面的最佳实践。一个由不同利益相关者组成的咨询委员会为清单的制定提供了信息。我们根据调查反馈和审查结果进行了修订。

结果

我们提出了21项扩展项目,涵盖全球循证医学网 - 麦克马斯特GDC的18个指南制定主题中的16个。主要新增内容包括规划在指南制定活动中与经历不平等的个人进行互动、应用公平视角,以及在推荐制定、传播和实施策略中考虑健康公平。该清单重视实际生活经验以丰富健康公平评估,补充实证证据以为指南推荐提供信息。指南制定者应评估指南对健康公平的敏感性,以确定资源优先级,以便最佳地实施扩展项目。

解读

全球循证医学网 - 麦克马斯特健康公平扩展为在整个指南制定过程中简化健康公平考量的整合提供了指导。将此工具与原始的全球循证医学网 - 麦克马斯特GDC一起使用,可能会产生更公平、更有影响力的指南。

资金

该项目部分由加拿大公共卫生署资助。资助者未参与项目的概念化、设计或实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4600/11992520/1b507250f077/gr1.jpg

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