4.4. Guideline Development Group decision-making

All policy recommendations should ideally be formulated through a consensus process based on the judgements of the Guideline Development Group, informed by the evidence (especially certainty or uncertainty about the benefit–harm balance) and by the expertise and experience of the group members. In the development of these guidelines there were occasions where consensus was not reached, and members of the Guideline Development Group resorted to a voting process. A recommendation or decision would stand if more than two thirds of the Guideline Development Group voted in support of it, unless the disagreement was related to a safety concern. A summary of the voting is presented in the GRADE evidence-todecision frameworks (see Online annexes).

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