Objectives: Despite published guidance by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group (GWG) on the use of good practice statement (GPS), their appropriate development remains challenging. In this article, we provide updated guidance with nuanced operationalization.
Study design and setting: We developed the updated guidance based on examples and iterative discussions. The lead authors refined the approach according to the feedback from GRADE Working Group meetings. We presented the summary of the results to all attendees of the GRADE Working Group meeting for feedback in September 2023 and for final approval in September 2024.
Results: We leverage the five signaling questions from the original guidance and recommend that guideline developers select relevant Evidence to Decision (EtD) criteria to assess the potential downstream consequences of implementing the statement. We have updated the definition of a GPS, classifying it into three categories: GPS grounded in ethics and human rights; GPS grounded in essential principles, practices, and protocols; and GPS grounded in established scientific evidence. Practical examples accompany each step as they relate to each type of GPS. Additionally, we introduce a tool to streamline GPS development and enhance the reporting process.
Conclusions: In this GRADE guidance article, we provide an update on when and how to develop a GPS. Adherence to the guidance will add to the trustworthiness of guidelines and minimize the inappropriate or overuse of the GPS.
DEWIDAR Omar;
AKL Elie;
MORGANO Gian Paolo;
PARMELLI Elena;
SAZ-PARKINSON Zuleika;
LANGENDAM Miranda;
MEERPOHL Joerg J;
MARTI Melanie;
MAYER Martin;
DJULBELGOVIC Benjamin;
BRIGNARDELLO-PETERSES Romina;
CHU Derek K;
MURAD Hassan H;
CANELO-AYBAR Carlos;
MATHEW Joseph L;
ALONSO COELLO Pablo;
QASEEM Amir;
SCHWINGSHACKL Lukas;
BOGNANNI Antonio;
ROJAS REYES Maria Ximena;
MORGAN Rebecca L;
KLUGAR Miloslav;
RIGAU David;
STALLINGS Elena;
IORIO Alfonso;
TUGWELL Peter;
DARZI Andrea;
TURGEON Alexis F.;
SHAMLIYAN Tatyana A;
MUNN Zachary;
MATHIOUDAKIS Alexander F.;
PIGGOTT Thomas;
LOFTI Tamara;
POTTIE Kevin;
GUYATT Gordon H;
SCHUNEMANN Holger;
2026-05-11
AMER COLL PHYSICIANS
JRC141417
1539-3704 (online),
https://www.acpjournals.org/doi/10.7326/ANNALS-25-00431#bibliography,
https://publications.jrc.ec.europa.eu/repository/handle/JRC141417,
10.7326/ANNALS-25-00431 (online),
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