How to Develop Trustworthy Evidence‐Informed Clinical and Public Health Guidelines in Oral Health: Methodological Strategies

OBJECTIVES: To identify barriers for the development of evidence-informed guidelines and propose potential methodological strategies addressing key barriers to producing trustworthy evidence-informed guidelines in oral health (OH). METHODS: Findings from a qualitative study exploring barriers in OH guideline development were used, and an international working group of experts in guideline methodology and individuals with experience in clinical and public health guidelines in OH was recruited. Through an iterative consensus approach, the following steps were followed: (1) identification of barriers related to the guideline development process itself and could be addressed through implementing or enhancing methodological strategies; (2) determination of the relevance of these challenges for guideline developers and research methodologists; and (3) agreement on the content and structure of each methodological strategy to address a particular barrier. Current methodological handbooks and publications on evidence-informed guideline development informed this process. The nominal group technique was used to reach consensus, concluding when no further comments were raised and the participants confirmed that no additional modifications were needed. RESULTS: Twelve experts from nine countries participated. The working group consolidated current methodology into nine strategies addressing 13 identified barriers. The document covers: defining when a document qualifies as an 'evidence-informed guideline'; practical approaches for defining guideline topics, scope, and questions; using pre-existing systematic reviews; formulating recommendations with limited or indirect evidence; developing recommendations on dental products; integrating economic considerations and people values and preferences; and involving non-dental healthcare professionals in OH guideline development. DISCUSSION: These strategies support guideline methodologists and lead developers in producing trustworthy clinical and public health guidelines in OH at global, regional, national, and subnational levels. They aim to improve the quality, consistency, and applicability of OH guidelines, facilitating integration of reliable evidence into oral healthcare decision-making to achieve better health outcomes and more effective health systems.