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The benefits of committing additional resources to the examination of qualitative evidence include the potential for reframing guidelines to fit with real-world concerns and issues for key stakeholders. It also provides an opportunity to maximise the impact of the resulting recommendations in practice for those funding, providing and using services. This observation aligns closely with the hypothesised benefits of both realist and implementation science, in which the interest is to understand not just what works, but how it works , in what contexts, and for what is commentary writing which individual and groups . For the QES conducted to inform the antenatal and intrapartum care guidelines, respectively , study selection was done by the review lead authors, one of whom was an expert in the field. As these guidelines were about healthy women receiving routine care, we excluded studies that fell outside of these parameters such as those including only women with specific pregnancy complications. Where there were doubts about specific studies, agreement on inclusion/exclusion was reached by consensus or adjudication by a third reviewer .

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All relevant editable source files must be uploaded during the submission process. Failing to submit these source files will cause unnecessary delays in the production process. Beyond these practical considerations, in our experience with two of the included guidelines , the inclusion of an a priori scoping review changed the focus of the guideline dramatically. In both cases, how to write a website in an essay this was a shift from an almost exclusive intention to reduce pathology, towards a need for maternity care to also catalyse positive maternal, newborn and family experiences. This legitimised the inclusion of effectiveness reviews on topics such as respectful care, companionship in labour and continuity of midwife care, alongside interventions such as pain-relief options.

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The CERQual tool includes four appraisal components and each finding is assessed against these criteria before being given an overall grade . For more information on the [ of CERQual, readers are referred to a recent series on the topic . WHO has recognised the need to improve its guideline methodology to ensure that guideline decision-making processes are transparent and evidence based, and that the resulting recommendations are relevant and applicable. Hence, the WHO Handbook for Guideline Development was produced. This stipulates that evidence of several criteria is required to inform a WHO guideline recommendation in addition to evidence of the effectiveness of an intervention . These other criteria include values and preferences, acceptability, feasibility and equity implications.

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We therefore used refutational analytic techniques (‘disconfirming analyses’) to minimize the risk that these presuppositions would skew the analysis and the interpretation of the findings” . WHO convened a group of methodologists involved in developing recent (2010–2018) guidelines that were informed by QES.

Qualitative Evidence Synthesis QES for Guidelines: Paper 1

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For both types of QES reviews, the standard PRISMA flow diagram should be presented to demonstrate the decisions that led to the final study inclusion . WHO convened a core team of authors who had been involved in WHO guideline technical teams since 2010 and in developing QES to support these guidelines. The external generalisability of guidelines compiled by WHO and other organisations has been a subject of debate . One of the critiques has been the lack of consultation with guideline users and anyone affected by guideline recommendations about the scope and setting of priorities for guidelines. Another is that the lack of transparency, around how and which knowledge informs the recommendations, limits their external validity and transferability to a range of contexts, cultures and individuals . Read the full instructions for submitting to a journal with the Flat Fee Agreement. A scientific justification for the study design, including the reasons why humane endpoints could not be used, and discussion of alternatives that were considered.