Using GRADE in public-health guidelines – challenges and some solutions?


Workshop session 9: Saturday, 14:00-15:30

Workshop category: 

  • Guideline development, adaptation, assessment and updating


Date and Location


Saturday 16 September 2017 - 14:00 to 15:30


Contact persons and facilitators

Contact person:


Srinivasa Katikireddi
Beth Shaw
Hilary Thomson


Nolan K1, O'Neill P1, Hilton-Boon M2
1 The National Institute for Health and Care Excellence (NICE), UK
2 MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK
Target audience

Target audience: 

Guideline developers, systematic reviewers (within Cochrane, Campbell, EPPI Centre and Joanna-Briggs), researchers, public health practitioners and users of guidelines.

Level of difficulty: 

Type of workshop

Type of workshop : 



Objectives: •Explore if and how GRADE approaches are applied to Public Health/ social Policy (PHP) guidelines.•Explore experiences and responses to challenges developers of PHP guidelines face in applying GRADE.
•Discuss how the GRADE PHP Working Group can support systematic reviewers and guideline developers.
Description: Developing PHP guidelines can be challenging for many reasons including: population-based intervention delivery; a highly heterogenous evidence base often constituted of non-randomised studies; the diverse range of stakeholders across multiple sectors; and the varying importance of outcomes to different stakeholders.
The workshop involves 3 parts:
1) Challenges introducing the GRADE approach to PHP in the UK (25 min).
Perceived challenges faced by the UK’s National Institute of Health and Care Excellence (NICE) will be presented and debated.
2) Detailed exploration of challenges developing PHP guidelines (45 min).
Attendees will consider in groups what challenges they are aware of, or anticipate experiencing, when using GRADE in PHP guidelines. Why some challenges occur to a lesser or greater extent than for clinical interventions will be explored, with reasoning elucidated through examples (inc from low/middle income countries).
3) Feedback and next steps (20 min).
The range of challenges faced and whether they can be met by existing GRADE approaches will be explored. We will finish by considering how a GRADE PHP group can support applying GRADE.