This is a protocol for a scoping review that aims to determine how guideline authors using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach have addressed previously identified challenges related to public health. The Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed. We will search and screen titles of guidelines for all languages published in 2013-2021 in: the GIN library, BIGG database, Epistemonikos GRADE guidelines repository, GRADEpro Database, MAGICapp, NICE and WHO websites. Two reviewers will independently screen full texts of the documents identified. The following information will be extracted: methods used for identifying different stakeholders and incorporating their perspectives; methods for identification and prioritization of non-health outcomes; methods for determining thresholds for decision-making; methods for incorporating and grading evidence from non-randomized studies; methods for addressing concerns with conditional recommendations in public health; methods for reaching consensus; additional methodological concerns; and any modifications made to GRADE. A combination of directed content analysis and descriptive statistics will be used for data analysis, and the findings presented narratively in a tabular and graphical form. In this protocol, we present the pilot results from 13 identified eligible guidelines issued between January and August 2021. We will publish the full review results when they become available.

1st Department of Neurology St Anne´s Faculty Hospital Faculty of Medicine Masaryk University Pekařská 664 53 656 91 Brno Czech Republic

Center of Evidence Based Education and Arts Therapies A JBI Affiliated Group Faculty of Education Palacky University Žižkovo nám 5 779 00 Olomouc Czech Republic

Czech National Centre for Evidence Based Healthcare and Knowledge Translation Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Kamenice 753 5 625 00 Brno Czech Republic

Department of Basic and Clinical Pharmacology and Toxicology Faculty of Medicine University of Rijeka Braće Branchetta 20 51000 Rijeka Croatia

Department of Health Research Methods Evidence and Impact McMaster University 1280 Main Street West Hamilton ON L8S 3L8 Canada

Department of Health Sciences Faculty of Medicine Masaryk University Kamenice 753 5 625 00 Brno Czech Republic

Department of Internal Medicine University of Kansas Medical Center 3901 Rainbow Boulevard Kansas City KS 66160 USA

Department of Medical Humanities School of Medicine University of Split Šoltanska 2 21000 Split Croatia

Department of Public Health Faculty of Medicine Masaryk University Kamenice 753 5 625 00 Brno Czech Republic

Department of Public Health School of Medicine University of Split Šoltanska 2 21000 Split Croatia

Department of Research in Biomedicine and Health School of Medicine University of Split Šoltanska 2 21000 Split Croatia

Institute of Special Education Studies Faculty of Education Palacky University Žižkovo nám 5 779 00 Olomouc Czech Republic

JBI Faculty of Health and Medical Sciences The University of Adelaide Adelaide SA 5005 Australia

MRC CSO Social and Public Health Sciences Unit University of Glasgow Berkeley Square 99 Berkeley Street Glasgow G3 7HR UK

PZU MK and RR Centar Medikal 7000 Bitola Macedonia

See more in PubMed

World Health Organization . Guidelines for WHO Guidelines. World Health Organization; Geneva, Switzerland: 2003.

Qaseem A., Forland F., Macbeth F., Ollenschläger G., Phillips S., van der Wees P. Guidelines International Network: Toward international standards for clinical practice guidelines. Ann. Intern. Med. 2012;156:525–531. doi: 10.7326/0003-4819-156-7-201204030-00009. PubMed DOI

Schünemann H., Brożek J., Guyatt G., Oxman A., editors. GRADE Handbook. 2013. [(accessed on 21 August 2021)]. Available online: https://gdt.gradepro.org/app/handbook/handbook.html.

Norris S.L., Rehfuess E.A., Smith H., Tunçalp Ö., Grimshaw J.M., Ford N.P., Portela A. Complex health interventions in complex systems: Improving the process and methods for evidence-informed health decisions. BMJ Glob. Health. 2019;4((Suppl. 1)):e000963. doi: 10.1136/bmjgh-2018-000963. PubMed DOI PMC

Hilton Boon M., Thomson H. Challenges in applying the GRADE approach in public health guidelines and systematic reviews: A concept article from the GRADE Public Health Group. J. Clin. Epidemiol. 2021;135:42–53. doi: 10.1016/j.jclinepi.2021.01.001. PubMed DOI PMC

Munn Z., Peters M.D.J. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med. Res. Methodol. 2018;18:143. doi: 10.1186/s12874-018-0611-x. PubMed DOI PMC

Peters M.D.J., Godfrey C. Chapter 11: Scoping Reviews (2020 Version) In: Aromataris E., Munn Z., editors. JBI Manual for Evidence Synthesis. JBI; Adelaide, Australia: 2020. DOI

Peters M.D.J., Marnie C. Updated methodological guidance for the conduct of scoping reviews. JBI Evid. Synth. 2020;18:2119–2126. doi: 10.11124/JBIES-20-00167. PubMed DOI

Tricco A.C., Lillie E. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann. Intern. Med. 2018;169:467–473. doi: 10.7326/M18-0850. PubMed DOI

Page M.J., McKenzie J.E. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. J. Clin. Epidemiol. 2021;134:178–189. doi: 10.1016/j.jclinepi.2021.03.001. PubMed DOI

Akl E.A., Kennedy C. Using GRADE methodology for the development of public health guidelines for the prevention and treatment of HIV and other STIs among men who have sex with men and transgender people. BMC Public Health. 2012;12:386. doi: 10.1186/1471-2458-12-386. PubMed DOI PMC

Rehfuess E.A., Akl E.A. Current experience with applying the GRADE approach to public health interventions: An empirical study. BMC Public Health. 2013;13:9. doi: 10.1186/1471-2458-13-9. PubMed DOI PMC

Burford B.J., Rehfuess E. Assessing evidence in public health: The added value of GRADE. J. Public Health. 2012;34:631–635. doi: 10.1093/pubmed/fds092. PubMed DOI

Hsieh H.-F., Shannon S.E. Three Approaches to Qualitative Content Analysis. Qual. Health Res. 2005;15:1277–1288. doi: 10.1177/1049732305276687. PubMed DOI

World Health Organization . WHO Antenatal Care Recommendations for a Positive Pregnancy Experience: Nutritional Interventions Update: Zinc Supplements during Pregnancy. World Health Organization; Geneva, Switzerland: 2021. PubMed

World Health Organization . WHO guideline on the Prevention of Drowning through Provision of Day-Care and Basic Swimming and Water Safety Skills. World Health Organization; Geneva, Switzerland: 2021. PubMed

World Health Organization . Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach. World Health Organization; Geneva, Switzerland: 2021. PubMed

World Health Organization . Recommendations and Guidance on Hepatitis C Virus Self-Testing. World Health Organization; Geneva, Switzerland: 2021. PubMed

World Health Organization . WHO Guideline on Self-Care Interventions for Health and Well-Being. World Health Organization; Geneva, Switzerland: 2021.

World Health Organization . WHO Guideline on School Health Services. World Health Organization; Geneva, Switzerland: 2021.

World Health Organization . Guideline: Infant Feeding in Areas of Zika Virus Transmission. World Health Organization; Geneva, Switzerland: 2021. PubMed

World Health Organization . WHO Guideline on Health Workforce Development, Attraction, Recruitment and Retention in Rural and Remote Areas. World Health Organization; Geneva, Switzerland: 2021. PubMed

World Health Organization . Updated Recommendations on Service Delivery for the Treatment and Care of People Living with HIV. World Health Organization; Geneva, Switzerland: 2021. PubMed

World Health Organization . WHO Guideline on the Dairy Protein Content in Ready-to-Use Therapeutic Foods for Treatment of Uncomplicated Severe Acute Malnutrition. World Health Organization; Geneva, Switzerland: 2021. PubMed

Promoting 2SLGBTQI+ Health Equity (Registered Nurses’ Association of Ontario) [(accessed on 6 August 2021)]. Available online: https://rnao.ca/bpg/guidelines/promoting-2slgbtqi-health-equity.

Behaviour Change: Digital and Mobile Health Interventions (National Institute for Heatlh and Care Excellence (NICE)) [(accessed on 6 August 2021)]. Available online: www.nice.org.uk/guidance/ng183.

World Health Organization . WHO Guidelines for Malaria. World Health Organization; Geneva, Switzerland: 2021.