PDF(Sci-hub)
Abstract：
BACKGROUND: WHO has recognised the need to ensure that guideline processes are transparent and evidence based, and that the resulting recommendations are relevant and applicable. Along with decision-making criteria that require findings from effectiveness reviews, WHO is increasingly using evidence derived from qualitative evidence syntheses (QES) to inform the values, acceptability, equity and feasibility implications of its recommendations. This is the first in a series of three papers examining the use of QES in developing clinical and health systems guidelines.
METHODS: WHO convened a group of methodologists involved in developing recent (2010-2018) guidelines that were informed by QES. Using a pragmatic and iterative approach that included feedback from WHO staff and other stakeholders, the group reflected on, discussed and identified key methods and research implications from designing QES and using the resulting findings in guideline development. Our aim in this paper is to (1) describe and discuss how the findings of QES can inform the scope of a guideline and (2) develop findings for key guideline decision-making criteria.
RESULTS: QES resulted in the addition of new outcomes that are directly relevant to service users, a stronger evidence base for decisions about how much effective interventions and related outcomes are valued by stakeholders in a range of contexts, and a more complete database of summary evidence for guideline panels to consider, linked to decisions about values, acceptability, feasibility and equity.
CONCLUSIONS: Rigorously conducted QES can be a powerful means of improving the relevance of guidelines, and of ensuring that the concerns of stakeholders, at all levels of the healthcare system and from a wide range of settings, are taken into account at all stages of the process.
METHODS: WHO convened a group of methodologists involved in developing recent (2010-2018) guidelines that were informed by QES. Using a pragmatic and iterative approach that included feedback from WHO staff and other stakeholders, the group reflected on, discussed and identified key methods and research implications from designing QES and using the resulting findings in guideline development. Our aim in this paper is to (1) describe and discuss how the findings of QES can inform the scope of a guideline and (2) develop findings for key guideline decision-making criteria.
RESULTS: QES resulted in the addition of new outcomes that are directly relevant to service users, a stronger evidence base for decisions about how much effective interventions and related outcomes are valued by stakeholders in a range of contexts, and a more complete database of summary evidence for guideline panels to consider, linked to decisions about values, acceptability, feasibility and equity.
CONCLUSIONS: Rigorously conducted QES can be a powerful means of improving the relevance of guidelines, and of ensuring that the concerns of stakeholders, at all levels of the healthcare system and from a wide range of settings, are taken into account at all stages of the process.
摘要：
背景：世卫组织认识到有必要确保指南过程透明且以证据为基础，以及由此产生的建议是相关和适用的。除了需要有效性审查结果的决策标准之外，世卫组织越来越多地使用来自定性证据综合(QES)的证据来告知价值，可接受性,其建议的公平性和可行性含义。这是研究QES在制定临床和卫生系统指南中使用的三篇论文中的第一篇。
方法：世卫组织召集了一组方法学专家参与制定近期（2010-2018年）的指南，这些指南由QES提供。采用务实和反复的方法，包括世卫组织工作人员和其他利益攸关方的反馈意见，小组反思，讨论并确定了设计QES并在指南开发中使用所得结果的关键方法和研究意义。本文的目的是（1）描述和讨论QES的发现如何为指南的范围提供信息，以及（2）为关键指南决策标准制定发现。
结果：QES导致增加了与服务用户直接相关的新结果，更强有力的证据基础，可以决定利益相关者在各种情况下评估多少有效干预措施和相关结果，以及一个更完整的摘要证据数据库，供指南小组考虑，与关于价值观的决定有关，可接受性,可行性和公平性。
结论：严格进行QES可以成为提高指南相关性的有力手段，并确保利益相关者的关切，在医疗保健系统的各个层面和广泛的环境中，在该过程的所有阶段都被考虑在内。
方法：世卫组织召集了一组方法学专家参与制定近期（2010-2018年）的指南，这些指南由QES提供。采用务实和反复的方法，包括世卫组织工作人员和其他利益攸关方的反馈意见，小组反思，讨论并确定了设计QES并在指南开发中使用所得结果的关键方法和研究意义。本文的目的是（1）描述和讨论QES的发现如何为指南的范围提供信息，以及（2）为关键指南决策标准制定发现。
结果：QES导致增加了与服务用户直接相关的新结果，更强有力的证据基础，可以决定利益相关者在各种情况下评估多少有效干预措施和相关结果，以及一个更完整的摘要证据数据库，供指南小组考虑，与关于价值观的决定有关，可接受性,可行性和公平性。
结论：严格进行QES可以成为提高指南相关性的有力手段，并确保利益相关者的关切，在医疗保健系统的各个层面和广泛的环境中，在该过程的所有阶段都被考虑在内。
