Systematic reviews of values and preferences: methodological challenges, approaches and implications for clinical guideline development

Systematic reviews of values and preferences are essential to ensure that healthcare decision-making and clinical practice guidelines reflect what truly matters to patients, caregivers, policymakers, and other interest-holders. These reviews synthesize evidence on how people value different health outcomes and provide critical information about the trade-offs they are willing to make (e.g. the willingness to accept an intervention’s side effects to gain a meaningful benefit for a more highly valued outcome). The importance of these reviews in developing trustworthy guidelines is evident, yet limited methodological guidance exists. The process of conducting these reviews presents unique methodological challenges. This paper addresses these challenges by providing a systematic, step-by-step guide for planning and conducting value and preference reviews. We detail key considerations for each stage, from formulating the review question to assessing the certainty of evidence and illustrate these methodological approaches with examples from published reviews to enhance practical understanding.