After content analysis, eight themes (seven selleck for CPG developers, one for CPG users) were identified as following (see online supplementary appendix 3). Then based on them, we outlined

an integrated CPG development process for developers, including seven steps in total (see figure 2). Figure 2 Overview of clinical practice guidelines development process (for CPGs developers). For CPG developers: Scoping questions Seven studies19 20 26–32 reported the development of CPGs should include ‘Scoping questions’ by which CPG developers could consider the reasons for addressing equity in their CPG (ie, differential effectiveness across groups, negative impact of guideline without equity considerations, and improving overall effectiveness of guideline within equity),19 the scenario and timing when equity should be addressed (eg, the presence of differential effects across groups),26 targeted populations, social determinants of health specified by PROGRESS or PROGRESS-Plus frameworks,6 7 and the changes and comments from stakeholders for the proposed question.28 29 Searching relevant evidence Four of the included studies20 28–32 (six publications) described the ‘Searching relevant evidence’ theme, including

appropriate study designs, changing search strategies when necessary, using terms/markers for equity and appraising the eligibility criteria. Appraising evidence and recommendations Five studies20 26–31 with seven publications fulfilled the ‘Appraising evidence and recommendations’

theme, including the appraisal of scientific evidence, such as the appraisal of appropriate modifiers, study design, sample size, analysis methods, the applicability and relevance of evidence, influence of equity evidences, the quality of evidence, the necessity of evidence and making changes and evidence gaps, as well as the appraisal of recommendations, such as the relevance of recommendations, the impact of recommendations and the quality of development process. Formulating recommendations Three studies20 28–31 with five publications provided guidance for how CPG developers should formulate recommendations to address equity issues as well as the elements that should be considered when synthesising the evidence and formulating recommendations, including analysing different subgroup effects, listing different/inconsistent evidence, balancing harms and benefits for disadvantaged GSK-3 populations, formulating equitable recommendations (such as considering barriers and facilitators of interventions for disadvantaged populations and mitigating negative effects that may produce inequities during the formulation of recommendations), and how to advance recommendations and adjust recommendations. Monitoring implementation Four studies20 26 27 30 31 with five publications described the ‘Monitoring implementation’ theme. These studies included guidance on what should be considered during the implementation of CPGs and how to monitor implementation.