GRADE Concept Series| Volume 131, P133-140, March 2021

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GRADE Concept Paper 1: Validating the “F.A.C.E” instrument using stakeholder perceptions of feasibility, acceptability, cost, and equity in guideline implement

Published:November 30, 2020DOI:


      Background and Objective

      To present a structured approach for assessing stakeholder perceptions and implementing the approach in guideline development.


      This work was carried out by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Equity and Stakeholder Engagement Project Groups through brainstorming and iterative frameworks, stakeholder engagement, pilot testing, refinement of ideas, using input from workshops, and discussions at GRADE Working Group meetings to produce this document, which constitutes a GRADE conceptual article on implementation.


      We introduce the FACE implementation criteria, feasibility, acceptability, cost, and equity; priority; and “intent to implement” criterion. We outline the implementation importance of networks and approaches to patient and other stakeholder engagement. Implementation is often highly contextual and can benefit from stakeholder engagement and other assessments. Our FACE approach provides stakeholder questions and language to inform guideline implementation and tools.


      The FACE criteria propose a series of knowledge translation questions to guide the assessment of implementation for evidence-based guidelines. It is desirable for guideline developers to use a conceptual approach, such as FACE, to tailor implementation and inform end of guideline dissemination and knowledge translation activities.


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