Recommendation mapping of the World Health Organization's guidelines on tuberculosis: A new approach to digitizing and presenting recommendations

Having up-to-date health policy recommendations accessible in one location is in high demand by guideline users. We developed an easy to navigate interactive approach to organize recommendations and applied it to tuberculosis (TB) guidelines of the World Health Organization (WHO). We used a mixed-methods study design to develop a framework for recommendation mapping with seven key methodological considerations. We define a recommendation map as an online repository of recommendations from several guidelines on a condition, providing links to the underlying evidence and expert judgments that inform them, allowing users to filter and cross-tabulate the search results. We engaged guideline developers, users, and health software engineers in an iterative process to elaborate the WHO eTB recommendation map. Applying the seven-step framework, we included 228 recommendations, linked to 103 guideline questions and organized the recommendation map according to key components of the health question, including the original recommendations and rationale (https://who.tuberculosis.recmap.org/). The recommendation mapping framework provides the entire continuum of evidence mapping by framing recommendations within a guideline questions’ population, interventions, and comparators domains. Recommendation maps should allow guideline developers to organize their work meaningfully, standardize the automated publication of guidelines through links to the GRADEpro guideline development tool, and increase their accessibility and usability. •What this adds to what is known: This work transfers evidence mapping methods to guidelines in a process we call “recommendation mapping.”•What is the implication, what should change now: Recommendation mapping provides a digital curation of guidelines for a particular condition or disease. In this article we describe how we created an online map of WHO guidance on tuberculosis prevention and care to enhance accessibility of recommendation data and other key guideline components, facilitate their prompt update as needed, allow cross-tabulation of recommendations to help visualize any priority gaps and clustering and facilitate the adaptation of recommendations by users.•Recommendation maps are accessory to the notion of “living guidelines” that are promptly updated to reflect the state of the science, providing a digital solution to improve upon the organization, accessibility, and ultimately, uptake of guideline recommendations to benefit in