![]() Because health system and public health interventions are often complex, detailed implementation considerations should be made when making a decision. Criteria listed in the assessment section of the health system and public health framework cover the important factors for making these types of decisions in addition to the effects and economic impact of an option, the priority of the problem, the impact of the option on equity, and its acceptability and feasibility are important considerations that can inform both whether and how to implement an option. ![]() FindingsĪll the GRADE EtD frameworks share the same basic structure, including sections for formulating the question, making an assessment and drawing conclusions. We applied the framework to diverse examples, conducted workshops and user testing with health system and public health guideline developers and policy-makers, and observed and tested its use in real-life guideline panels. Developing the frameworkīuilding on GRADE EtD tables, we used an iterative approach, including brainstorming, consultation of the literature and with stakeholders, and an international survey of policy-makers. We developed the GRADE Evidence to Decision (EtD) framework for health system and public health decisions as part of the DECIDE project, in which we simultaneously developed frameworks for these and other types of healthcare decisions, including clinical recommendations, coverage decisions and decisions about diagnostic tests. To describe a framework for people making and using evidence-informed health system and public health recommendations and decisions.
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