Improving the use of research evidence in guideline development: 10. Integrating values and consumer involvement
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Open Access
Review
Improving the use of research evidence in guideline development: 10. Integrating values and consumer involvement Holger J Schünemann*1, Atle Fretheim2 and Andrew D Oxman2 Address: 1INFORMA/CLARITY Research Group, S.C. Epidemiologia, Istitituto Regina Elena, Via Elio Chianesi 53, 00144 Rome, Italy and 2Norwegian Knowledge Centre for the Health Services, P.O. Box 7004, St. Olavs plass, N-0130 Oslo, Norway Email: Holger J Schünemann* - [email protected]; Atle Fretheim - [email protected] ; Andrew D Oxman - [email protected] * Corresponding author
Published: 05 December 2006 Health Research Policy and Systems 2006, 4:22
doi:10.1186/1478-4505-4-22
Received: 07 April 2006 Accepted: 05 December 2006
This article is available from: http://www.health-policy-systems.com/content/4/1/22 © 2006 Schünemann 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 10th 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 integrating values and consumers in guideline development. Methods: We searched PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We reviewed the titles of all citations and retrieved abstracts and full text articles if the citations appeared relevant to the topic. We checked the reference lists of articles relevant to the questions and used snowballing as a technique to obtain additional information. We did not conduct a full systematic review ourselves. Our conclusions based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. Key questions and answers: We did not find a systematic review of methods for integrating values in guidelines, but we found several systematic reviews that dealt with related topics. Whose values should WHO use when making recommendations? • Values, the relative importance or worth of a state or consequences of a decision (outcomes relating to benefits, harms, burden and costs), play a role in every recommendation. Ethical considerations, concepts that determine what is right, also play a role. • The values used in making recommendations should reflect those of the people affected. Judgements should be explicit and should be informed by input from those affected (including citizens, patients, clinicians and policy makers). • When differences in values may lead to diff
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