title: How equity is addressed in clinical practice guidelines: a content analysis.
abstract: OBJECTIVE
  Considering equity into guidelines presents methodological challenges. This study aims to qualitatively synthesise the methods for incorporating equity in clinical practice guidelines (CPGs).
  
  
  METHODS
  Content analysis of methodological publications.
  
  
  METHODS
  Methodological publications were included if they provided checklists/frameworks on when, how and to what extent equity should be incorporated in CPGs.
  
  
  METHODS
  We electronically searched MEDLINE, retrieved references, and browsed guideline development organisation websites from inception to January 2013. After study selection by two authors, general characteristics and checklists items/framework components from included studies were extracted. Based on the questions or items from checklists/frameworks (unit of analysis), content analysis was conducted to identify themes and questions/items were grouped into these themes.
  
  
  METHODS
  The primary outcomes were methodological themes and processes on how to address equity issues in guideline development.
  
  
  RESULTS
  8 studies with 10 publications were included from 3405 citations. In total, a list of 87 questions/items was generated from 17 checklists/frameworks. After content analysis, questions were grouped into eight themes ('scoping questions', 'searching relevant evidence', 'appraising evidence and recommendations', 'formulating recommendations', 'monitoring implementation', 'providing a flow chart to include equity in CPGs', and 'others: reporting of guidelines and comments from stakeholders' for CPG developers and 'assessing the quality of CPGs' for CPG users). Four included studies covered more than five of these themes. We also summarised the process of guideline development based on the themes mentioned above.
  
  
  CONCLUSIONS
  For disadvantaged population-specific CPGs, eight important methodological issues identified in this review should be considered when including equity in CPGs under the guidance of a scientific guideline development manual.
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
authors.forename: Chunhu
authors.initials: C
authors.lastname: Shi
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Tian
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China The First Clinical Medicine School, Lanzhou University, Lanzhou, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Centre for Global Health, University of Ottawa, Ottawa, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Petkovic
authors.affiliation: The First Clinical Medicine School, Lanzhou University, Lanzhou, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Ren
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
authors.forename: Kehu
authors.initials: K
authors.lastname: Yang
authors.affiliation: School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
mesh_terms: D057189:Checklist / Q000592:standards*; D003625:Data Collection; D006801:Humans; D016239:MEDLINE / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011642:Publications / Q000592:standards*; D011643:Publishing / Q000458:organization & administration*; D012189:Retrospective Studies
keywords: PUBLIC HEALTH; QUALITATIVE RESEARCH