Adaptation Frameworks for Clinical Guidelines and Proposing a Framework for Iran: A Review and Comparative Study (original) (raw)
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2021
Background: Transfer of a process, technology or method from one setting to another is often challenging and clinical practice guideline adaptation is not an exception. The aim of this study was to identify the challenges of clinical practice guideline adaptation in Iran and provide lessons for developing countries.Methods: In this qualitative study, purposeful interviews were conducted with 17 participants from guideline adaptation groups in research centers , knowledge management and health department of Tehran University of Medical Sciences and experts in ministry of health. Data was analyzed using qualitative content analysis. Results: The identified challenges were classified into two basic and operational categories. Basic challenges include believing in need to guideline adaptation, position of adaptation in evaluation and reward systems, access to financial resources and supervision of adaptation process. Also operational challenges were adaptation methodology, forming adapt...
Journal of Evaluation in Clinical Practice, 2015
Rationale, aims and objectives The ADAPTE methodology for adaptation of guidelines has been used by many organizations to develop high-quality clinical practice guidelines. Although it is a valid alternative for de novo development of guidelines, it might demand more time and resources in some institutions. The present study demonstrates the proposed 'adapted ADAPTE' methodology to support more clarity, simplicity and practicality. It also aims at avoiding duplication within the process and reducing the resources and time allocated to the CPG adaptation projects. Methods Clinical guidelines' adaptation in the Center for Evidence-Based Clinical Practice Guidelines at the Alexandria Faculty of Medicine and University Hospitals involves two stages: (1) cross-sectional or retrospective study to reveal the current practice and prescribing patterns concerning the selected health topic; (2) the 'adapted ADAPTE' methodology for CPGs adaptation that was based on the original ADAPTE Process. Results The 'adapted ADAPTE' included three modified tools, three new tools based on the original ADAPTE framework and alternatives for four ADAPTE steps to enhance utilization. The finalized adapted CPGs included nine high priority topics for paediatrics and two topics for emergency medicine. Conclusions The ADAPTE methodology for guideline adaptation can be customized or 'adapted' to the local health care setting and resources. This proposal facilitates supports and improves the utilization and update of the ADAPTE process by CPG programmes or activities in health care organizations. This is of particular importance in health care systems in developing countries with limited resources in the Eastern Mediterranean region like Egypt. the well-known contributions of Guyatt and Sackett from McMaster University [1-3]. Currently, EBM or the more global concepts of evidence-based health care (EBHC) and knowledge translation (KT) are considered cornerstone in medical education and in the clinical practice of medicine. The knowledge-to-action or evidence-to-practice cycle was proposed by Graham et al. as a model to support closing the clinical care gap between research evidence and clinical practice [4]. Clinical practice guidelines (CPGs) have been proposed as one of the powerful applications or solutions of EBHC and KT [5]. Several international initiatives helped shaping of the standards for high quality CPGs. The foundation of the Cochrane Collaboration in 1993 that provides high-quality systematic reviews and research evidence syntheses [6], the 23 criteria of the Appraisal of Guide-bs_bs_banner
Adaptation of clinical guidelines: literature review and proposition for a framework and procedure
International Journal for Quality in Health Care, 2006
Purpose. The development and updating of high-quality clinical practice guidelines require substantial resources. Many guideline programmes throughout the world are using similar strategies to achieve similar goals, resulting in many guidelines on the same topic. One method of using resources more efficiently and avoiding unnecessary duplication of effort would be to adapt existing guidelines. The aim was to review the literature on adaptation of guidelines and to propose a systematic approach for adaptation of guidelines.
Methods used in adaptation of health-related guidelines: A systematic survey
Journal of global health, 2017
Adaptation refers to the systematic approach for considering the endorsement or modification of recommendations produced in one setting for application in another as an alternative to de novo development. To describe and assess the methods used for adapting health-related guidelines published in peer-reviewed journals, and to assess the quality of the resulting adapted guidelines. We searched Medline and Embase up to June 2015. We assessed the method of adaptation, and the quality of included guidelines. Seventy-two papers were eligible. Most adapted guidelines and their source guidelines were published by professional societies (71% and 68% respectively), and in high-income countries (83% and 85% respectively). Of the 57 adapted guidelines that reported any detail about adaptation method, 34 (60%) did not use a published adaptation method. The number (and percentage) of adapted guidelines fulfilling each of the ADAPTE steps ranged between 2 (4%) and 57 (100%). The quality of adapte...
Adaptation of international evidence based clinical practice guidelines: The ADAPTE process
Middle East Fertility Society Journal, 2013
Evidence-based clinical practice guidelines are important tools to unify practice and improve patient's outcomes in terms of morbidity and mortality. The generation of EBCPGs is not an easy task. It requires a lot of resources, expertise and time. So, in low resources countries, adaptation of high quality guidelines is the way to go. This can be done in a scientific way using the ADAPTE methodology and toolkits.
Adaptation of Clinical Practice Guidelines
2008
A rigorous development process of clinical practice guidelines through a systematic appraisal of available evidence is costly and time consuming. One way to reduce the costs and time, and avoid unnecessary duplication of effort of guideline development is by relying on a local adaptation approach of guidelines developed at the (inter)national level by expert groups. In this chapter we survey the work on guideline adaptation, which includes methodologies, case studies, assessment of effectiveness, and related work on guideline adaptation in the Artificial Intelligence community.
Journal of evaluation in clinical practice, 2017
Clinical Practice Guidelines are mostly developed by 3 methods; namely, de novo, adoption, and adaptation. Nonpublished studies and authors experience shows that most guidelines in Turkey are either by adoption or by adaptation. There is no available local tool for adaptation, so the process is not standardized and most of the time not explicitly defined. The objective of this study is to search for international guideline adaptation tools and test their feasibility in Turkish context, to serve a final goal of developing a unique local strategic tool for guideline adaptation. The methodological design of this study includes selection of an international tool for Clinical Practice Guideline adaptation, piloting this tool with selected Turkish guidelines, identifying the feasibility of this tool and exploring the needs for adaptation of the tool, drawing recommendations for adaptation of the strategies, and validation of the process by local experts. The study from planning phase to f...
2019
Rationale, aims, and objectives: Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration between the Research Chair for Evidence-Based Healthcare and Knowledge Translation and the Quality Management Department. This study aims to develop a fast-track method for adaptation of evidence-based CPGs and describe results of the program. Methods: Twenty-two clinical departments participated in the program. Following a CPGs awareness week directed to all health care professionals (HCPs), 22 teams were trained to set priorities, search, screen, assess, select, and customize the best available CPGs. The teams were technically supported by the program's CPG advisors. To address the local health care context, a modified version of the ADAPTE was used YSA and HAW have equal contributions to the manuscript.