Abstract
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Objectives: The objective of this study was to develop the
Guidelines for Recommendation Reporting (G-RECO) for use in the Public
Health Weekly Report (PHWR) in Korea, aiming to improve the
standardization, scientific accuracy, and practical applicability of
recommendation reports in clinical practice guidelines.
Methods: The methodology of this study aligned with the EQUATOR
Network standards. A multidisciplinary research committee was formed, comprising
experts in various relevant fields. The development process included a
comprehensive literature review, analysis of existing guidelines, and
formulation of a structured G-RECO framework with 21 key items. This was
supplemented with Explanation & Elaboration documents for each item. The
draft underwent rigorous revisions and evaluations by both internal and external
experts.
Results: By November 2023, significant progress had been made in
developing a detailed G-RECO checklist and accompanying E&E documents.
These tools are designed to guide authors in clear and consistent reporting of
recommendation reports. The team is poised to finalize and publish the checklist
and E&E documents by December 2024.
Conclusion: The G-RECO guidelines represent a significant
advancement in the formalization and standardization of recommendation reports
for the PHWR. They are expected to improve the quality of research and
publications in clinical practice guidelines, contributing to the evolution of
the field and enriching public health discourse. The guidelines, with their
comprehensive nature and user-friendly design, will become an invaluable
resource for researchers, editors, and peer reviewers in public health and
epidemiology.
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Keywords: Recommendation report; Reporting guideline; Study protocol
Introduction
Clinical practice guidelines are recommendations systematically developed to assist
physicians and patients in making decisions in specific clinical situations. These
guidelines not only provide systematic directions for improving the quality of
medical care, but are also a strategy for providing high-quality information to
patients. They play a significant role in improving patient satisfaction and
treatment efficacy by aiding in decision-making, which can influence appropriate
patient treatment.
The Korea Disease Control and Prevention Agency (KDCA) develops numerous clinical
practice guidelines. Unlike general clinical practice guidelines, the KDCA's
guidelines focus on disease prevention, such as screening and vaccination, and also
address certain diseases, such as sexually transmitted infections and
tuberculosis.
Currently, there are two reporting guidelines for clinical practice guidelines: RIGHT
(Reporting Items for practice Guidelines in HealThcare) [
1] and AGREE (Appraisal of Guidelines for Research &
Evaluation) [
2]. Both are widely used and have
similar items, but they also complement each other. Notably, RIGHT includes a public
version that can be utilized [
3]. These
reporting guidelines can be directly applied when reporting on health and disease
policy in a weekly report. However, since KDCA's clinical practice guidelines
primarily focus on disease prevention and some infectious diseases, it is advisable
to select the most relevant items from these guidelines and report accordingly.
In this context, we aimed to develop the Guidelines for Recommendation Reporting
(G-RECO) for publications in Public Health Weekly Report (PHWR) in
Korea. This document is a study protocol that outlines the process of developing
G-RECO.
Methods
The methodology employed in this project adheres to the standards set by the
Enhancing the Quality and Transparency of Health Research (EQUATOR) Network [
4]. This approach encompasses a multi-faceted
strategy, involving a varied team of specialists, to formulate robust reporting
guidelines.
The multidisciplinary research committee is instrumental in the development of
reporting guidelines. This committee is composed of experts in various fields:
specialists in preventive medicine who focus on strategies for disease
prevention, epidemiologists analyzing disease patterns and trends,
methodologists dedicated to ensuring the scientific rigor of research
methodologies and data analysis, family medicine practitioners offering insights
on effective community health management, public health professionals who ensure
the alignment of the guidelines with broader health policies, and journal
editors who contribute to the clarity and practicability of the guidelines.
Through collaborative efforts in workshops and team meetings, this diverse group
of experts has synthesized their collective expertise to create thorough,
scientifically robust, and practically relevant reporting guidelines.
Literature review: Public Health Weekly Report
Our team conducted a thorough review of PHWR manuscripts in Korea (
https://www.phwr.org/), specifically focusing on recommendation
reports. The PHWR is the official academic journal of the KDCA. Its primary
objective is to promptly and accurately provide evidence-based scientific
information to the public and health professionals both domestically and
internationally. This information is based on the KDCA's research,
surveillance, and investigation findings. The journal covers a range of topics,
including infectious diseases, chronic diseases, environmentally induced
illnesses, injuries and poisoning, and health promotion. It features research
papers, outbreak reports, surveillance updates, field reports, reviews and
forecasts, and policy reports. Its publications are intended for a wide range of
audiences, including healthcare professionals, policymakers, and sometimes the
general public, offering timely insights into ongoing public health issues and
trends.
The manuscripts were carefully examined to identify unique features, research
methods, and key components crucial to report recommendations. Following this
extensive review, a joint meeting with all team members was held. The aim was to
merge our findings, discuss the differences and similarities in reporting styles
among each report, and find any gaps in the literature. The insights from these
discussions were vital in forming the new reporting guidelines, ensuring they
meet current needs and advance the standards of recommendation reporting in
health research.
Reviewing existing reporting guidelines
This stage involved closely scrutinizing and categorizing existing reporting
guidelines, including the RIGHT [
1] and
the AGREE statement. [
2] The main goal was
to assess the suitability and effectiveness of these guidelines for clinical
practice guidelines in the PHWR. This included examining each guideline’s
structure, key components, and overall approach to report recommendation. Both
the RIGHT and the AGREE aim to improve the transparency and quality of guideline
reporting, but they focus on slightly different aspects of guideline development
and evaluation. The AGREE emphasizes methodological quality assessment, while
the RIGHT checklist is considerably shorter and could be easier to use, with
similar results [
5].
The formulation of the G-RECO guidelines involved a structured procedure
orchestrated by our panel of experts. The preliminary version stemmed from
comprehensive insights gathered through an extensive review of relevant
literature and critical analysis of existing reporting guidelines, ensuring that
G-RECO is in line with current practices and integrates the latest field
advancements. The structure of G-RECO is segmented into various key sections
(including title, abstract, summary, introduction, methodology, results,
discussion, and other pertinent information), with each section requiring
specific details to ensure thorough reporting. Altogether, these sections
encompass 21 key items.
For each item of the guideline, we incorporated Explanation & Elaboration
(E&E) documents, providing clarity on the rationale and context, thereby
increasing the practicality of the guidelines. During this phase, the committee
played an essential role by structurally formulating each guideline item. These
items are grounded in evidence, deriving from the collective expertise of the
committee, critical review of the literature, and contemporary guidelines. This
collaborative process ensured comprehensive coverage of all critical elements of
recommendation reporting, with an emphasis on scientific precision and practical
utility.
The draft guidelines and E&E documents underwent successive revisions,
where they were applied to select literature to evaluate their practicality,
with adjustments made based on the feedback received. The drafts were reviewed
by both our internal team and external experts proficient in recommendation
reporting, employing a scoring method for a detailed assessment of each
component of the guidelines and the E&E documents.
Finally, we compiled the final iteration of the guidelines along with an
extensive manual. The checklist will serve as a succinct guide for researchers,
while the manual provides in-depth explanations and illustrations for diverse
recommendation scenarios. This systematic and evidence-grounded approach ensures
that the final guidelines are comprehensive, current, and pragmatically
applicable.
Ongoing updates and revisions
The G-RECO guidelines are planned to undergo systematic, ongoing updates. This
continuous revision process is essential to maintain their relevance and
effectiveness in response to evolving challenges, scientific progress, and
emerging best practices within the field. To guarantee that these updates are
both timely and impactful, the G-RECO guidelines will undergo regular
evaluations, ensuring that they reflect the most current advancements in this
domain. A crucial aspect of this updating mechanism involves collecting and
incorporating feedback from a diverse array of stakeholders, including
researchers, public health professionals, epidemiologists, and policymakers.
Their insights will be crucial in pinpointing areas for improvement, thereby
ensuring that the guidelines remain attuned to the needs and expectations of
their users.
Results
By November 2023, the research team has made considerable advancements in formulating
detailed reporting guidelines for recommendation reports. Progressing methodically,
the team has been meticulously crafting a thorough checklist and E&E
documents. These tools are intended to guide authors in presenting recommendation
reports with both clarity and consistency. The team is on track to finalize and
release both the checklist and the E&E documents by December 2024.
Discussion
The introduction of the G-RECO guidelines represents a significant advancement in the
formalization of clinical practice guidelines and recommendations for the PHWR.
Reporting guidelines, identified as checklists, flow diagrams, or structured texts,
serve as comprehensive aids for authors in documenting specific research types
[
6]. These instruments are invaluable to a
range of stakeholders, including peer reviewers, authors, and academic journals,
ensuring accurate and complete research documentation. The G-RECO guidelines are
particularly designed to assist researchers in effectively communicating the
strengths and limitations of their findings, thereby enhancing their interpretation
and practical application.
Moreover, the G-RECO framework is a vital tool for editorial teams and peer
reviewers. It provides a systematic approach for assessing the validity and
relevance of research submissions, promoting high standards of scientific accuracy
and clarity in publications related to recommendations. This is especially crucial
in contexts where the accuracy and reliability of health-related information are
paramount.
The G-RECO guidelines are further augmented by the inclusion of detailed explanations
and examples for each checklist item, as elaborated in the appendix. This method
increases the comprehensibility and practicality of the guidelines, offering
concrete guidance for implementation. The provision of specific examples makes the
guidelines more accessible and user-friendly, reducing potential misinterpretations
or errors during manuscript preparation.
In the future, it is expected that the broad implementation of G-RECO guidelines will
significantly improve the standard of research for clinical practice guidelines and
recommendations. As familiarity with these guidelines grows within the research
community, an improvement in the quality of publications related to recommendations
is foreseen, which will likely have a substantial impact on advancing the field and
enriching discussions in public health.
Conclusions
Our team is committed to developing the G-RECO guidelines to improve the
standardization of recommendation reports for the PHWR, providing a framework
that bolsters the scientific precision, clarity, and practical relevance of
research in this area. These guidelines, by offering a systematic method for
manuscript development and assessment, not only promote increased clarity and
uniformity in research documentation, but also contribute to elevating the
caliber of publications within the realm of clinical practice guidelines.
G-RECO's comprehensive design, encompassing a detailed checklist and
illustrative examples, positions it as an invaluable tool for researchers,
editors, and peer reviewers. This initiative is key in raising the quality of
clinical practice guidelines and thus plays a significant role in enriching the
wider conversation in public health and epidemiology.
Authors' contributions
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Project administration: Choi BY, Kim SY
Conceptualization: Ryu S, Ryu SY, Ha M, Choi BY, Kim SY
Methodology & data curation: Jung W, Ryu S, Ryu SY, Ha M
Writing - original draft: Jung W, Kim SY
Writing - review & editing: Jung W, Ryu S, Ryu SY, Ha M, Choi BY, Kim
SY
Conflict of interest
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No potential conflict of interest relevant to this article was reported.
Funding
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This research was funded through the support of the Policy Research and
Development Service Project (202305210001) from the Korea Disease Control and
Prevention Agency.
Data availability
-
Not applicable.
Acknowledgments
We extend our gratitude to Ms. JiHye Kwon for her invaluable administrative
assistance.
Supplementary materials
-
Not applicable.
References
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- 2. Brouwers MC, Kerkvliet K, Spithoff K. The AGREE Reporting Checklist: a tool to improve reporting of
clinical practice guidelines. BMJ 2016;352:i1152
- 3. Wang X, Chen Y, Akl EA, Tokalić R, Marušić A, Qaseem A, et al. The reporting checklist for public versions of guidelines:
RIGHT-PVG. Implement Sci 2021;16(1):10
- 4. The EQUATOR Network. How to develop a reporting guideline [Internet] Oxford (UK), The EQUATOR Network. c2018;[cited 2024 May 24]. Available from https://www.equator-network.org/toolkits/developing-a-reporting-guideline/
- 5. Tokalić R, Viđak M, Buljan I, Marušić A. Comparison of RIGHT and AGREE reporting checklists for healthcare
practice guidelines. Cochrane Database Syst Rev 2018;(9):Suppl 1. 188-189.
- 6. Kim SY. Reporting guidelines. Korean J Fam Med 2009;30(1):62
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