Table 2 Reasons for initial conditional and non-approval of submissions to the Guidelines Review Committee in 2014–2017
From: Common issues raised during the quality assurance process of WHO guidelines: a cross-sectional study
Reasons | n (%) | |
|---|---|---|
Conditionally approved | Not approved | |
Guideline proposalsa | ||
Problematic introduction and scope | 25 (78.1) | 14 (93.3) |
Inadequate formulation of the key (‘PICO’) questions underpinning the recommendations | 29 (90.6) | 15 (100) |
Suboptimal composition or inadequate description of the guideline contributor groups | 32 (100) | 15 (100) |
WHO departments: inadequate representation or lack of clarity in staff members’ roles | 19 (59.4) | 10 (66.7) |
GDG: inadequate diversity with respect to gender, WHO regions, low- and middle-income countries, technical expertise, and stakeholder perspectives or lack of clarity in members’ roles | 29 (90.6) | 15 (100) |
Systematic review team, methodologist: inadequate description or lack of clarity in their roles | 13 (40.6) | 11 (73.3) |
Concerns regarding reporting or assessment of DOI, management of COI or funding sources or inadequate description thereof | 20 (62.5) | 13 (86.7) |
Inadequate methods for evidence retrieval or inadequate description thereofb | 24 (75.0) | 14 (93.3) |
Inadequate description of the considerations for formulating recommendationsc | 29 (90.6) | 14 (93.3) |
Inadequate description of how values and preferences will be examined and inform the recommendations, including the perspectives that will be considered | 7 (21.9) | 7 (46.7) |
Final guidelinesa | ||
Suboptimal composition or inadequate description of the guideline contributor groups | 21 (56.8) | 18 (64.3) |
WHO departments: inadequate representation or lack of clarity in staff members’ roles | 5 (13.5) | 4 (14.3) |
GDG: inadequate diversity with respect to gender, WHO regions, low- and middle income countries, technical expertise, and stakeholder perspectives or lack of clarity in members’ roles | 17 (46.0) | 9 (32.1) |
External review group: inadequate diversity with respect to gender, WHO regions, technical expertise, stakeholder and consumer representation or lack of clarity in members’ roles | 11 (29.7) | 11 (39.3) |
Concerns regarding reporting or assessment of DOI, management of COI or funding sources or inadequate description thereof | 20 (54.1) | 19 (67.9) |
Inadequate methods for evidence retrieval or inadequate description thereofd | 37 (100) | 21 (75.0) |
Inadequate information on quality assessment of the evidencee | 34 (91.9) | 20 (71.4) |
Problems with recommendations | 37 (100) | 28 (100) |
Inadequate description of the expert group’s decision-making processf | 17 (46.0) | 16 (57.1) |
Inadequate consideration of the key factors relevant to the decision-making processg | 32 (86.5) | 23 (82.1) |
Unclear rationale for the strength of recommendation(s) | 28 (75.7) | 26 (92.9) |
Suboptimal wording or content of the recommendation(s) | 27 (73.0) | 20 (71.4) |
Inadequate considerations of the contextual factors associated with recommendation(s) | 29 (29.7) | 6 (21.4) |