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Volume 14 Issue 4
Jul.  2023
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WANG Qi, LUO Xufei, WANG Zijun, YANG Nan, ZHU Di, LI Zhewei, XIN Xin, YANG Zhenhua, WANG Ling, SHI Qianling, CHEN Yaolong. WHO SMART Guidelines: A New Direction for Guideline Development and Implementation[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 868-874. DOI: 10.12290/xhyxzz.2023-0274
Citation: WANG Qi, LUO Xufei, WANG Zijun, YANG Nan, ZHU Di, LI Zhewei, XIN Xin, YANG Zhenhua, WANG Ling, SHI Qianling, CHEN Yaolong. WHO SMART Guidelines: A New Direction for Guideline Development and Implementation[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 868-874. DOI: 10.12290/xhyxzz.2023-0274
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WHO SMART Guidelines: A New Direction for Guideline Development and Implementation

  • 1.

    Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton L8S4L8, Canada

  • 2.

    McMaster Health Forum, McMaster University, Hamilton L8S4L8, Canada

  • 3.

    WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China

  • 4.

    Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China

  • 5.

    School of Public Health, Lanzhou University, Lanzhou 730000, China

  • 6.

    Electrical and Computer Engineering Department, University of Pittsburgh, Pittsburgh, Pennsylvania 15217, USA

  • 7.

    Institute of Information Photonics and Optical Communications, Beijing University of Posts and Telecommunications, Beijing 100000, China

  • 8.

    The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China

  • 9.

    Institute of Health Data Science, Lanzhou University, Lanzhou 730000, China

  • 10.

    Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China

  • 11.

    Research Unit of Evidence-based Evaluation and Guidelines, Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China

Funds: 

Fundamental Research Funds for the Central Universities lzujbky-2021-ey13

More Information
  • Corresponding author:

    CHEN Yaolong, E-mail: chevidence@lzu.edu.cn

  • Received Date: June 06, 2023
  • Accepted Date: June 25, 2023
  • Available Online: July 09, 2023
  • Issue Publish Date: July 29, 2023
    Graphical Abstract
    • Abstract
  • The quality and methodology of guidelines developed by the World Health Organization (WHO) have been continuously improved after decades of development and reform. However, the implementation of conventional guidelines faces certain challenges, including lengthy timelines, the possible loss of accuracy and consistency of recommendations, and limited capacity of some countries to support guideline adaptation and implement. As a result, the expected effects of guideline recommendations may not be fully achieved. As many countries are investing heavily in digital health systems, both the WHO and its Member States have recognized the importance of digital implementation of guidelines and developed the SMART Guidelines. As a new approach, SMART Guidelines can accelerate the implementation of evidence-based recommendations in the digital age, enhance their compliance and implementability, and improve healthcare quality and population outcomes. This article aims to provide an overview of the background, definition, framework, and knowledge layers of the WHO SMART Guidelines, using antenatal care guidelines as an example for interpretation.
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    • References (32)
  • [1]
    World Health Organization. WHO handbook for guideline development, 2nd ed[M/OL ]. (2014-12-18). [2023-06-07]. https://www.who.int/publications/i/item/9789241548960.
    [2]
    World Health Organization. About WHO[EB/OL]. [2023-06-07]. https://www.who.int/zh/about.
    [3]
    Gopinathan U, Hoffman SJ. Institutionalising an evidence-informed approach to guideline development: progress and challenges at the World Health Organization[J]. BMJ Glob Health, 2018, 3: e000716. DOI: 10.1136/bmjgh-2018-000716
    [4]
    Oxman AD, Lavis JN, Fretheim A. Use of evidence in WHO recommendations[J]. Lancet, 2007, 369: 1883-1889. DOI: 10.1016/S0140-6736(07)60675-8
    [5]
    丁泓帆, 常晓楠, 杨楠, 等. WHO指南评审原则与方法[J]. 中国循证医学杂志, 2016, 16: 478-481. DOI: 10.7507/1672-2531.20160073

    Ding HF, Chang XN, Yang N, et al. Review Principles and Methods of WHO Guidelines[J]. Zhongguo Xunzheng Yixue Zazhi, 2016, 16: 478-481. DOI: 10.7507/1672-2531.20160073
    [6]
    World Health Organization. WHO handbook for guideline development, 1st Edition[M/OL ]. [2023-06-07]. https://apps.who.int/iris/bitstream/handle/10665/75146/9789241548441_eng.pdf?sequence=1.
    [7]
    Norris SL, Louis H, Sawin VI, et al. An evaluation of WHO emergency guidelines for Zika virus disease[J]. J Evid Based Med, 2019, 12: 218-224. DOI: 10.1111/jebm.12347
    [8]
    Norris SL, Ford N. Improving the quality of WHO guidelines over the last decade: progress and challenges[J]. Lancet Glob Health, 2017, 5: e855-e856. DOI: 10.1016/S2214-109X(17)30253-X
    [9]
    Burda BU, Chambers AR, Johnson JC. Appraisal of guidelines developed by the World Health Organization[J]. Public Health, 2014, 128: 444-474. DOI: 10.1016/j.puhe.2014.01.002
    [10]
    Wang X, Chen Y, Yao L, et al. Reporting of declarations and conflicts of interest in WHO guidelines can be further improved[J]. J Clin Epidemiol, 2018, 98: 1-8. DOI: 10.1016/j.jclinepi.2017.12.021
    [11]
    Wang X, Zhou Q, Chen Y, et al. Using RIGHT (Reporting Items for Practice Guidelines in Healthcare) to evaluate the reporting quality of WHO guidelines[J]. Health Res Policy Syst, 2020, 18: 75. DOI: 10.1186/s12961-020-00578-w
    [12]
    Sinclair D, Isba R, Kredo T, et al. World Health Organization Guideline Development: An Evaluation[J]. PLoS One, 2013, 8: e63715. DOI: 10.1371/journal.pone.0063715
    [13]
    Mehl DG. SMART Guidelines: Advancing Guideline Use in the Digital Age[EB/OL ]. (2021-02)[2023-06-07]. https://cdn.who.int/media/docs/default-source/digital-heal-th-documents/who.
    [14]
    World Health Organization. From paper to digital pathway: WHO launches first 'SMART Guidelines'[EB/OL ]. (2021-02-18)[2023-06-07]. https://www.who.int/news/item/18-02-2021-from-paper-to-digital-pathway-who-launches-first-smart-guidelines.
    [15]
    World Health Organization. SMART Guidelines[EB/OL ]. [2023-06-07]. https://www.who.int/teams/digital-health-and-innovation/smart-guidelines.
    [16]
    World Health Organization. Global strategy on digital health 2020—2025[M/OL ]. [2023-06-07]. https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf.
    [17]
    World Health Organization. WHO Guideline: recommendations on digital interventions for health system strengthening[M/OL ]. (2019-06-06)[2023-06-07]. https://www.who.int/publications-detail-redirect/9789241550505.
    [18]
    Sutton RT, Pincock D, Baumgart DC, et al. An overview of clinical decision support systems: benefits, risks, and strategies for success[J]. NPJ Digit Med, 2020, 3: 17. DOI: 10.1038/s41746-020-0221-y
    [19]
    Mehl G, Tunçalp Ö, Ratanaprayul N, et al. WHO SMART guidelines: optimising country-level use of guideline recommendations in the digital age[J]. Lancet Digit Health, 2021, 3: e213-e216. DOI: 10.1016/S2589-7500(21)00038-8
    [20]
    Boxwala AA, Rocha BH, Maviglia S, et al. A multi-layered framework for disseminating knowledge for computer-based decision support[J]. J Am Med Inform Assoc, 2011, 18: i132-i139. DOI: 10.1136/amiajnl-2011-000334
    [21]
    World Health Organization. WHO Antenatal Care (ANC) SMART Guideline[M/OL ]. [2023-06-07]. https://anc.srhr.org/#Tools.
    [22]
    Vogel JP, Dowswell T, Lewin S, et al. Developing and applying a "living guidelines" approach to WHO recommendations on maternal and perinatal health[J]. BMJ Glob Health, 2019, 4: e001683. DOI: 10.1136/bmjgh-2019-001683
    [23]
    Barreix M, Lawrie TA, Kidula N, et al. Development of the WHO Antenatal Care Recommendations Adaptation Toolkit: a standardised approach for countries[J]. Health Res Policy Syst, 2020, 18: 70. DOI: 10.1186/s12961-020-00554-4
    [24]
    Lattof SR, Moran AC, Kidula N, et al. Implementation of the new WHO antenatal care model for a positive pregnancy experience: a monitoring framework[J]. BMJ Glob Health, 2020, 5: e002605. DOI: 10.1136/bmjgh-2020-002605
    [25]
    World Health Organization. Digital adaptation kit for antenatal care: operational requirements for implementing WHO recommendations in digital systems[M/OL ]. (2021-02-17)[2023-06-07]. https://www.who.int/publications/i/item/9789240020306.
    [26]
    Shivers J, Amlung J, Ratanaprayul N, et al. Enhancing narrative clinical guidance with computer-readable artifacts: Authoring FHIR implementation guides based on WHO recommendations[J]. J Biomed Inform, 2021, 122: 103891. DOI: 10.1016/j.jbi.2021.103891
    [27]
    Haddad SM, Souza RT, Cecatti JG, et al. Building a Digital Tool for the Adoption of the World Health Organization's Antenatal Care Recommendations: Methodological Intersection of Evidence, Clinical Logic, and Digital Technology[J]. J Med Internet Res, 2020, 22: e16355. DOI: 10.2196/16355
    [28]
    Rajkomar A, Oren E, Chen K, et al. Scalable and accurate deep learning with electronic health records[J]. NPJ Digit Med, 2018, 1: 18. DOI: 10.1038/s41746-018-0029-1
    [29]
    Muliokela R, Uwayezu G, Ngoc CT, et al. Integration of new digital antenatal care tools using the WHO SMART guideline approach: Experiences from Rwanda and Zambia[J]. Digit Health, 2022, 8: 20552076221076256.
    [30]
    Tamrat T, Ratanaprayul N, Barreix M, et al. Transitioning to digital systems: The role of World Health Organization's digital adaptation kits in operationalizing recommendations and interoperability standards[J]. Glob Health Sci Pract, 2022, 10: e2100320. DOI: 10.9745/GHSP-D-21-00320
    [31]
    World Health Organization. Digital adaptation kit for family planning: operational requirements for implementing WHO recommendations in digital systems[M/OL ]. (2021-06-25)[2023-06-07]. https://www.who.int/publications/i/item/9789240029743.
    [32]
    World Health Organization. Digital adaptation kit for HIV: operational requirements for implementing WHO recommendations and standards in digital systems[M/OL ]. (2022-07-29)[2023-06-07]. https://www.who.int/publications/i/item/9789240054424.
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