Assessment of evidence and its grading

The development of these guidelines required a substantial evidence review and assessment using the GRADE process, as stipulated by WHO's Guidelines Review Committee [7]. The systematic reviews focused primarily on the randomized controlled trials with direct comparison between the intervention and comparator. However, data on the outcomes from the observational cohort studies were also summarized and assessed by the GDGs, especially when limited or no evidence from randomized controlled trials was available.

Table 2. Implications of the strength of a recommendation for different users

The GDG membership represented a broad cross-section of experts, future users of the guidelines as well as affected persons. All decisions about the recommendations were reached by discussion and consensus, including on the strength of the recommendations and, where appropriate, the conditions to be attached to the recommendations. The GDG chairs facilitated the discussions in order to reach consensus during the meetings.

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