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00925njm 22002777a 4500 dc Dewidar, Omar author Lotfi, Tamara author Langendam, Miranda W author Parmelli, Elena author Saz-Parkinson, ZuleiKa author Solo, Karla author Chu, Derek K author Mathew, Joseph L author Akl, Elie A author Brignardello-Petersen, Romina author Mustafa, Reem A author Moja, Lorenzo author Iorio, Alfonso author Chi, Yuan author Canelo-Aybar, Carlos author Kredo, Tamara author Karpusheff, Justine author Turgeon, Alexis F author Alonso-Coello, Pablo author Wiercioch, Wojtek author Gerritsen, Annette author Klugar, Miloslav author Rojas, María Ximena author Tugwell, Peter author Welch, Vivian Andrea author Pottie, Kevin author Munn, Zachary author Nieuwlaat, Robby author Ford, Nathan author Stevens, Adrienne author Khabsa, Joanne author Nasir, Zil author Leontiadis, Grigorios author Meerpohl, Joerg author Piggott, Thomas author Qaseem, Amir author Matthews, Micayla author Schünemann, Holger J author eCOVID-19 recommendations map collaborators author 2023-06 An evidence-based approach is considered the gold standard for health decision-making. Sometimes, a guideline panel might judge the certainty that the desirable effects of an intervention clearly outweigh its undesirable effects as high, but the body of supportive evidence is indirect. In such cases, the application of the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach for grading the strength of recommendations is inappropriate. Instead, the GRADE Working Group has recommended developing ungraded best or good practice statement (GPS) and developed guidance under which circumsances they would be appropriate.Through an evaluation of COVID-1- related recommendations on the eCOVID Recommendation Map (COVID-19.recmap.org), we found that recommendations qualifying a GPS were widespread. However, guideline developers failed to label them as GPS or transparently report justifications for their development. We identified ways to improve and facilitate the operationalisation and implementation of the GRADE guidance for GPS.Herein, we propose a structured process for the development of GPSs that includes applying a sequential order for the GRADE guidance for developing GPS. This operationalisation considers relevant evidence-to-decision criteria when assessing the net consequences of implementing the statement, and reporting information supporting judgments for each criterion. We also propose a standardised table to facilitate the identification of GPS and reporting of their development. This operationalised guidance, if endorsed by guideline developers, may palliate some of the shortcomings identified. Our proposal may also inform future updates of the GRADE guidance for GPS. BMJ Evid Based Med. 2023 Jun;28(3):189-196. 10.1136/bmjebm-2022-111962 2515-4478 BMJ evidence-based medicine 35428694 http://hdl.handle.net/20.500.12105/16141 COVID-19 Evidence-Based Practice Good or best practice statements: proposal for the operationalisation and implementation of GRADE guidance