Improving the use of research evidence in guideline development: 2. Priority setting
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Improving the use of research evidence in guideline development: 2. Priority setting Andrew D Oxman*1, Holger J Schünemann2 and Atle Fretheim3 Address: 1Norwegian Knowledge Centre for the Health Services, P.O. Box 7004, St. Olavs plass, N-0130 Oslo, Norway, 2INFORMA, S.C. Epidemiologia, Istitituto Regina Elena, Via Elio Chianesi 53, 00144 Rome, Italy and 3Norwegian Knowledge Centre for the Health Services, P.O. Box 7004, St. Olavs plass, N-0130 Oslo, Norway Email: Andrew D Oxman* - [email protected]; Holger J Schünemann - [email protected]; Atle Fretheim - [email protected] * Corresponding author
Published: 29 November 2006 Health Research Policy and Systems 2006, 4:14
doi:10.1186/1478-4505-4-14
Received: 07 April 2006 Accepted: 29 November 2006
This article is available from: http://www.health-policy-systems.com/content/4/1/14 © 2006 Oxman et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: 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 second 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. Objectives: We reviewed the literature on priority setting for health care guidelines, recommendations and technology assessments. Methods: 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. Key questions and answers: There is little empirical evidence to guide the choice of criteria and processes for establishing priorities, but there are broad similarities in the criteria that are used by various organisations and practical arguments for setting priorities explicitly rather than implicitly, What criteria should be used to establish priorities?: • WHO has limited resources and capacity to develop recommendations. It should use these resources where it has the greatest chance of improving health, equity, and efficient use of healthcare resources. • We suggest the following criteria for establishing priorities for developing recommendations based on WHO's aims and strategic advantages: • Problems associated with a high burden of illness in low and middle-income countries, or new and emerging diseases. • No existing recommendations of good quality. • The feasibility of developing recommendations that will improve health outcomes, reduce inequities or reduce unnec
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