New guidance on using qualitative evidence synthesis for guidelines (2)

11 August, 2019

Dear Simon (Simon Lewin, Norway: )

Thank you for sharing this new series of three papers. These are so relevant to HIFA and particularly to thework of the HIFA Evidence-Informed Policy and Practice group, which has been supported by TDR and WHO (sponsorship opportunity available for future support!) For the benefit of HIFA members who may not have immediate web access, and to stimulate questions and discussion, I am going to pass on the citations and abstract. Here are the citation and abstract of paper 1:

CITATION: Qualitative Evidence Synthesis (QES) for Guidelines: Paper 1 – Using qualitative evidence synthesis to inform guideline scope and develop qualitative findings statements

Soo Downe, Kenneth W. Finlayson, Theresa A. Lawrie, Simon A. Lewin, Claire Glenton, Sarah Rosenbaum, María Barreix and Özge Tunçalp


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.


Best wishes, Neil

Coordinator, HIFA Project on Evidence-Informed Policy and Practice

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: