Few guidance publications described how to assess the quality of CPGs which considered equity issues in their recommendations, the process for developing Paclitaxel microtubule CPGs, or how to report equity considerations. NHMRC,30 Keuken et al,31 Aldrich et al20 and NICE28 29 covered more than five themes. All included studies reported the ‘scoping questions’ theme. When a guideline is developed, a rational for equity considerations should be described based on the differential effectiveness of interventions between

subgroups. The PROGRESS and PROGRESS-Plus acronyms are recommended for identifying potentially disadvantaged groups when describing the scope of the CPG.6 Four studies20 28–32 described the ‘searching relevant evidence’ theme, but, only NICE28 29 suggested the consideration of study design. NHMRC30 and Aldrich et al20 provided search terms on equity issues. Identifying evidence including systematic reviews, clinical practice guidelines, randomised controlled trials and supplementary literature is essential for CPG development. The search strategy must be transparent and reproducible. The reporting of databases, time periods, key words, subject headings, language restrictions, grey literature and eligibility criteria should be considered.35 Before formulating recommendations, the quality of scientific evidence must be appraised by appropriate

appraisal tools. The relevance, applicability, impact of evidence on equity and evidence gaps should be assessed. Equity-specific CPG developers should focus on important questions, for example whether CPGs gave priority to the disadvantaged, how the applicability of the CPG and its evidence for disadvantaged populations was assessed, and whether implementation and monitoring strategies

will detect effects for the most disadvantaged.36 When evidence gaps exist, expert opinion or consensus is necessary to allow CPG developers to highlight future research needs.35 NHMRC30 and Aldrich et al20 provide strategies that can be used when there is a lack of evidence. For specific population subgroups, guideline developers should counterpoise harms and benefits of interventions, consider barriers and facilitators of interventions, and adjust recommendations for specific settings. Only Dans AM (2007) provided an equity lens to appraise the quality of a CPG with equity considerations. For the development of a CPG, we suggest that a Anacetrapib well-designed handbook such as the ‘WHO handbook for guideline development’,32 ‘SIGN 50 A guideline developer’s handbook’,37 ‘Handbook on Clinical Practice Guidelines’38 or NICE ‘the guidelines manual 2012’28 is utilised. The process of CPG development (figure 2) outlined in this paper will be more effective when used in combination with the handbooks mentioned above. Limitations With the comprehensive search strategy, only eight studies (containing 87 questions or items) were included in this review.