A framework to guide decision-making in environmental and occupational health
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Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence-to- decision (EtD) frameworks provide a structure to support standardized and transparent consideration of all relevantcriteria to inform health decisions. The GRADE EtD was introduced in 2016 with five perspectives: individual clinical decisions, population-level clinical decisions, health system and public health decisions, coveragedecisions, and tests. Many environmental and occupational health (EOH) decision-makers have not adopted the EtD framework, possibly due to limited applicability of the existing five perspectives.