Improving the use of research evidence in guideline development: 6. Determining which outcomes are important
- PDF / 192,628 Bytes
- 6 Pages / 610 x 792 pts Page_size
- 69 Downloads / 232 Views
Open Access
Review
Improving the use of research evidence in guideline development: 6. Determining which outcomes are important Holger J Schünemann*1, Andrew D Oxman2 and Atle Fretheim2 Address: 1INFORMA, 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]; Andrew D Oxman - [email protected]; Atle Fretheim - [email protected] * Corresponding author
Published: 01 December 2006 Health Research Policy and Systems 2006, 4:18
doi:10.1186/1478-4505-4-18
Received: 07 April 2006 Accepted: 01 December 2006
This article is available from: http://www.health-policy-systems.com/content/4/1/18 © 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 sixth 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 determining which outcomes are important for the development of guidelines. Methods: We searched five databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct a complete systematic review 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: We did not find a systematic review that addresses any of the following key questions and we found limited relevant research evidence. What methods should WHO use to identify important outcomes? • Methods of outcome identification should be transparent and explicit. • The consultation process should start with identification of all relevant outcomes associated with an intervention. • Those affected, including consumers, should be involved in the selection of outcomes. • A question driven approach (what is important?) is preferable to a data driven approach (what data are at hand?) to identify important outcomes. What type of outcomes should WHO consider and how should cultural diversity be taken account of in the selection of outcomes? • Desirable (benefits, less burden and savings) and undesirable effects should be considered in all guidelines. • Undesirable effects include harms (including the possibility of unanticipated adverse effects), greater burden (e.g. having to go to the doctor) and costs (including opportunity costs). • Import
Data Loading...
