A New Taxonomy is Proposed for Defining the Interests of Stakeholders’ Representatives in Health Research: the Case of Guideline Development

Stakeholder engagement is increasingly recognized as essential to the development of practice guidelines [ [1] Armstrong M.J. Rueda J.D. Gronseth G.S. Mullins C.D. Framework for enhancing clinical practice guidelines through continuous patient engagement. Health Expect. 2017; 20: 3-10 Crossref PubMed Scopus (71) Google Scholar ]. In this context, a stakeholder group is one that either uses guideline recommendations to support health- and health care-related decisions or is affected by those decisions [ [2] Concannon T.W. Meissner P. Grunbaum J.A. McElwee N. Guise J.-M. Santa J. et al. A new taxonomy for stakeholder engagement in patient-centered outcomes research. J Gen Intern Med. 2012; 27: 985-991 Crossref PubMed Scopus (281) Google Scholar , [3] Petkovic J. Riddle A. Akl E.A. Khabsa J. Lytvyn L. Atwere P. et al. Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation. Syst Rev. 2020; 9: 1-11 Crossref PubMed Scopus (69) Google Scholar ]. Typical stakeholder groups engaged in guideline development include patients, members of the public, providers, and policy makers. Engaging a range of stakeholders in guideline development has the potential to enhance their credibility, which in turn could improve the likelihood of uptake of recommendations [ [4] Kastner M. Bhattacharyya O. Hayden L. Makarski J. Estey E. Durocher L. et al. Guideline uptake is influenced by six implementability domains for creating and communicating guidelines: a realist review. J Clin Epidemiol. 2015; 68: 498-509 Abstract Full Text Full Text PDF PubMed Scopus (103) Google Scholar ]. Together with ‘consumer and stakeholder involvement’ the GIN-McMaster guideline development checklist highlights ‘conflict of interest considerations’ as one of 18 topics for successful guideline enterprise [ [5] Schünemann H.J. Wiercioch W. Etxeandia I. Falavigna M. Santesso N. Mustafa R. et al. Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise. CMAJ. 2014; 186: E123-E142 Crossref PubMed Scopus (398) Google Scholar ]. Thus, one might ask how these two aspects of guideline development can exist in harmony.