TY - JOUR
T1 - Equity issues rarely addressed in the development of COVID-19 formal recommendations and good practice statements
T2 - a cross-sectional study
AU - Dewidar, Omar
AU - Bondok, Mostafa
AU - Abdelrazeq, Leenah
AU - Aliyeva, Khadija
AU - Solo, Karla
AU - Welch, Vivian
AU - Brignardello-Petersen, Romina
AU - Mathew, Joseph L.
AU - Hazlewood, Glen
AU - Pottie, Kevin
AU - Hartling, Lisa
AU - Khalifa, Dina Sami
AU - Duda, Stephanie
AU - Falavigna, Maicon
AU - Khabsa, Joanne
AU - Lotfi, Tamara
AU - Petkovic, Jennifer
AU - Elliot, Sarah
AU - Chi, Yuan
AU - Parker, Roses
AU - Kristjansson, Elizabeth
AU - Riddle, Alison
AU - Darzi, Andrea J.
AU - Magwood, Olivia
AU - Saad, Ammar
AU - Rada, Gabriel
AU - Neumann, Ignacio
AU - Loeb, Mark
AU - Reveiz, Ludovic
AU - Mertz, Dominik
AU - Piggott, Thomas
AU - Turgeon, Alexis F.
AU - Schünemann, Holger
AU - Tugwell, Peter
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/9
Y1 - 2023/9
N2 - Background and Objective: To identify COVID-19 actionable statements (e.g., recommendations) focused on specific disadvantaged populations in the living map of COVID-19 recommendations (eCOVIDRecMap) and describe how health equity was assessed in the development of the formal recommendations. Methods: We employed the place of residence, race or ethnicity or culture, occupation, gender or sex, religion, education, socio-economic status, and social capital-Plus framework to identify statements focused on specific disadvantaged populations. We assessed health equity considerations in the evidence to decision frameworks (EtD) of formal recommendations for certainty of evidence and impact on health equity criteria according to the Grading of Recommendations, Assessment, Development, and Evaluations criteria. Results: We identified 16% (124/758) formal recommendations and 24% (186/819) good practice statements (GPS) that were focused on specific disadvantaged populations. Formal recommendations (40%, 50/124) and GPS (25%, 47/186) most frequently focused on children. Seventy-six percent (94/124) of the recommendations were accompanied with EtDs. Over half (55%, 52/94) of those considered indirectness of the evidence for disadvantaged populations. Considerations in impact on health equity criterion most frequently involved implementation of the recommendation for disadvantaged populations (17%, 16/94). Conclusion: Equity issues were rarely explicitly considered in the development COVID-19 formal recommendations focused on specific disadvantaged populations. Guidance is needed to support the consideration of health equity in guideline development during health emergencies.
AB - Background and Objective: To identify COVID-19 actionable statements (e.g., recommendations) focused on specific disadvantaged populations in the living map of COVID-19 recommendations (eCOVIDRecMap) and describe how health equity was assessed in the development of the formal recommendations. Methods: We employed the place of residence, race or ethnicity or culture, occupation, gender or sex, religion, education, socio-economic status, and social capital-Plus framework to identify statements focused on specific disadvantaged populations. We assessed health equity considerations in the evidence to decision frameworks (EtD) of formal recommendations for certainty of evidence and impact on health equity criteria according to the Grading of Recommendations, Assessment, Development, and Evaluations criteria. Results: We identified 16% (124/758) formal recommendations and 24% (186/819) good practice statements (GPS) that were focused on specific disadvantaged populations. Formal recommendations (40%, 50/124) and GPS (25%, 47/186) most frequently focused on children. Seventy-six percent (94/124) of the recommendations were accompanied with EtDs. Over half (55%, 52/94) of those considered indirectness of the evidence for disadvantaged populations. Considerations in impact on health equity criterion most frequently involved implementation of the recommendation for disadvantaged populations (17%, 16/94). Conclusion: Equity issues were rarely explicitly considered in the development COVID-19 formal recommendations focused on specific disadvantaged populations. Guidance is needed to support the consideration of health equity in guideline development during health emergencies.
KW - COVID-19
KW - Disadvantaged populations
KW - Equity
KW - GRADE
KW - Guidelines
KW - Recommendations
UR - https://www.scopus.com/pages/publications/85168817231
U2 - 10.1016/j.jclinepi.2023.08.002
DO - 10.1016/j.jclinepi.2023.08.002
M3 - Article
C2 - 37562727
AN - SCOPUS:85168817231
SN - 0895-4356
VL - 161
SP - 116
EP - 126
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -