5. Peer-review of the questions

Evidence summaries and completed draft

The Micronutrients Unit within the WHO Department of Nutrition for Health and Development and the Nutrition Section of UNICEF has drafted a set of questions on vitamin A supplementation based on policy needs. They have distributed the draft questions to the WHO/UNICEF Steering Committee and will be shared with the Key External Experts and Stakeholders for comments.

The questions have been formatted in the PICO1 framework, listing key beneficial and harmful outcomes of the intervention in several population groups. The Key External Experts and Stakeholders are expected to review the questions through electronic communications. We ask that members of the panel comment on the relevance of these questions, modify them if required and add additional relevant questions.

Members of the Guideline Group will rate each beneficial and harmful outcome on a scale of 1-9. Outcomes which score on average between 7 and 9 will be considered “high priority”. Those outcomes which scored between 4 and 6 on average will be considered “important but not critical at this time”; while those scoring less than 4 will be considered “low priority at this time”. All responses will be returned to, and reviewed by, the WHO/UNICEF Steering Committee.

The Micronutrients Unit of WHO and the Nutrition Section of UNICEF will also draft evidence-based recommendations on vitamin A supplementation based on results of the GRADE evidence table using active, unambiguous, specific wording directed at two main target audience(s): policy makers and program implementers. We will distribute the draft recommendations to the WHO/UNICEF Steering Committee, and then to the Key External Experts and Stakeholders Panel. The recommendations will be finalized by the Guideline Group through a WHO/UNICEF Technical Consultation on Vitamin A Supplementation Guidelines.

The draft recommendations will be presented by the WHO staff, providing justification and reference to the relevant evidence summary. The evidence will be reviewed and discussed by the group, considering the balance of evidence for benefits and harms. Once agreement on a recommendation is achieved, the group will consider the costs, values, and preferences.

If necessary, the initial recommendation will be modified and final agreement on the recommendation will be sought.

  • Brown P et al. How to formulate research recommendations. British Medical Journal, 333:804-806, 2006.