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Abstract：
BACKGROUND: WHO has recognised the need to improve its guideline methodology to ensure that guideline decision-making processes are transparent and evidence based, and that the resulting recommendations are relevant and applicable. To help achieve this, WHO guidelines now typically enhance intervention effectiveness data with evidence on a wider range of decision-making criteria, including how stakeholders value different outcomes, equity, gender and human rights impacts, and the acceptability and feasibility of interventions. Qualitative evidence syntheses (QES) are increasingly used to provide evidence on this wider range of issues. In this paper, we describe and discuss how to use the findings from QES to populate decision-making criteria in evidence-to-decision (EtD) frameworks. This is the second in a series of three papers that examines the use of QES in developing clinical and health system guidelines.
METHODS: WHO convened a writing group drawn from the technical teams involved in its recent (2010-2018) guidelines employing 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.
RESULTS: We describe a step-wise approach to populating EtD frameworks with QES findings. This involves allocating findings to the different EtD criteria (how stakeholders value different outcomes, equity, acceptability and feasibility, etc.), weaving the findings into a short narrative relevant to each criterion, and inserting this summary narrative into the corresponding \'research evidence\' sections of the EtD. We also identify areas for further methodological research, including how best to summarise and present qualitative data to groups developing guidelines, how these groups draw on different types of evidence in their decisions, and the extent to which our experiences are relevant to decision-making processes in fields other than health.
CONCLUSIONS: This paper shows the value of incorporating QES within a guideline development process, and the roles that qualitative evidence can play in integrating the views and experiences of relevant stakeholders, including groups who may not be otherwise represented in the decision-making process.
METHODS: WHO convened a writing group drawn from the technical teams involved in its recent (2010-2018) guidelines employing 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.
RESULTS: We describe a step-wise approach to populating EtD frameworks with QES findings. This involves allocating findings to the different EtD criteria (how stakeholders value different outcomes, equity, acceptability and feasibility, etc.), weaving the findings into a short narrative relevant to each criterion, and inserting this summary narrative into the corresponding \'research evidence\' sections of the EtD. We also identify areas for further methodological research, including how best to summarise and present qualitative data to groups developing guidelines, how these groups draw on different types of evidence in their decisions, and the extent to which our experiences are relevant to decision-making processes in fields other than health.
CONCLUSIONS: This paper shows the value of incorporating QES within a guideline development process, and the roles that qualitative evidence can play in integrating the views and experiences of relevant stakeholders, including groups who may not be otherwise represented in the decision-making process.
摘要：
背景：世卫组织认识到需要改进其指南方法，以确保指南决策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。为了帮助实现这一点，世卫组织指南现在通常会增强干预措施有效性数据，并提供更广泛的决策标准证据。包括利益相关者如何评价不同的结果，股本，性别和人权影响，以及干预措施的可接受性和可行性。定性证据综合（QES）越来越多地用于为这一更广泛的问题提供证据。在本文中,我们描述并讨论了如何使用QES的结果来填充证据决策(EtD)框架中的决策标准.这是三篇研究QES在制定临床和卫生系统指南中的应用的系列论文中的第二篇。
方法：世卫组织召集了一个写作小组，该小组来自参与其最近（2010-2018年）采用QES的指南的技术团队。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。
结果：我们描述了一种使用QES结果填充EtD框架的分步方法。这涉及将调查结果分配到不同的EtD标准(利益相关者如何评价不同的结果，股本，可接受性和可行性，等。),将研究结果编织成与每个标准相关的简短叙述，并将此摘要叙述插入EtD的相应“研究证据”部分。我们还确定了进一步方法学研究的领域，包括如何最好地总结和向制定指南的小组提供定性数据，这些团体如何在他们的决定中利用不同类型的证据，以及我们的经验与卫生以外领域的决策过程相关的程度。
结论：本文显示了将QES纳入指南开发过程的价值，以及定性证据在整合相关利益相关者的观点和经验中可以发挥的作用，包括在决策过程中可能没有其他代表的群体。
方法：世卫组织召集了一个写作小组，该小组来自参与其最近（2010-2018年）采用QES的指南的技术团队。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。
结果：我们描述了一种使用QES结果填充EtD框架的分步方法。这涉及将调查结果分配到不同的EtD标准(利益相关者如何评价不同的结果，股本，可接受性和可行性，等。),将研究结果编织成与每个标准相关的简短叙述，并将此摘要叙述插入EtD的相应“研究证据”部分。我们还确定了进一步方法学研究的领域，包括如何最好地总结和向制定指南的小组提供定性数据，这些团体如何在他们的决定中利用不同类型的证据，以及我们的经验与卫生以外领域的决策过程相关的程度。
结论：本文显示了将QES纳入指南开发过程的价值，以及定性证据在整合相关利益相关者的观点和经验中可以发挥的作用，包括在决策过程中可能没有其他代表的群体。
