title: Using the Grade Approach to Support the Development of Recommendations for Public Health Interventions in Radiation Emergencies.
abstract: The World Health Organization (WHO) guideline development policy requires that WHO guidelines be developed in a manner that is transparent and based on all available evidences, which must be synthesised and formally assessed for quality. To fulfil this requirement, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach of rating quality of evidence and grading strength of recommendations was applied when developing the WHO recommendations on public health interventions in radiation emergencies. The guideline development group (GDG) formulated 10 PICO (P: population; I: intervention; C: comparator; O: outcomes) questions to guide the development of recommendations on response interventions during the early/intermediate and late emergency phases and on risk communications for mitigating psycho-social impact of radiation emergencies. For each PICO question, an extensive evidence search and systematic review was conducted. The GDG then formulated the recommendations using the evidence to recommendation (E-2-R) decision-making matrix and evaluated the strength of each recommendation.
authors: Department of Public Health and Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland CarrZ@who.int.
authors: Z
authors: Z
authors: Carr
authors: Evidence Aid and Northern Ireland Network for Trials Methodology Research , Queen's University Belfast, Belfast, Northern Ireland.
authors: M
authors: M
authors: Clarke
authors: Department of Internal Medicine, American University of Beirut, Lebanon and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
authors: E A
authors: EA
authors: Akl
authors: Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.
authors: R
authors: R
authors: Schneider
authors: Division of Radioprotection, Federal Office of Public Health , Bern, Switzerland.
authors: C
authors: C
authors: Murith
authors: Radiation Protection Bureau, Health Canada, Ottawa, Canada.
authors: C
authors: C
authors: Li
authors: Global Health Communication Center, Indiana University School of Liberal Arts, Indianapolis, IN, USA.
authors: J
authors: J
authors: Parrish-Sprowl
authors: Radiation Emergency Medicine Center, Karolinska Institutet and National Board of Health and Welfare, Stockholm, Sweden.
authors: L
authors: L
authors: Stenke
authors: National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention (NIRP, China CDC), Beijing, P.R. China.
authors: L
authors: L
authors: Cui-Ping
authors: Consultant in disaster risk reduction, Switzerland , Switzerland.
authors: S
authors: S
authors: Bertrand
authors: Consultant in nuclear and radiological environmental health , USA.
authors: C
authors: C
authors: Miller
mesh_terms: D047852:Chernobyl Nuclear Accident; D003142:Communication; D003657:Decision Making; D004189:Disaster Planning / Q000379:methods*; D004190:Disasters; D004630:Emergencies; D004781:Environmental Exposure; D019317:Evidence-Based Medicine; D005260:Female; D062406:Fukushima Nuclear Accident; D017408:Guidelines as Topic; D006801:Humans; D007564:Japan; D008297:Male; D055848:Nuclear Power Plants; D016273:Occupational Exposure; D016730:Program Development; D011634:Public Health; D011785:Quality Assurance, Health Care / Q000592:standards; D018788:Radioactive Hazard Release / Q000517:prevention & control*; D018570:Risk Assessment; D014455:Ukraine; D014944:World Health Organization