Extending the RIGHT statement for reporting adapted practice guidelines in healthcare: the RIGHT-Ad@pt Checklist protocol

Song, Yang; Darzi, Andrea; Ballesteros, Mónica; García, Laura Martínez; Alonso‐Coello, Pablo; Arayssi, Thurayya; Bhaumik, Soumyadeep; Chen, Yaolong; Cluzeau, Françoise; Ghersi, Davina; Padilla, Paulina Fuentes; Langlois, Étienne V; Vernooij, Robin W.M.; Akl, Elie A.

doi:10.1136/bmjopen-2019-031767

Cited by 21 publications

(18 citation statements)

References 41 publications

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“…The maximum score for each AGREE domain, of which there are six, is 100%. Landmark reference standards include the AGREE II tool [ 9 ], or the RIGHT extension (Reporting Items for practice Guidelines in Healthcare) for alternative guideline development methods [ 24 ]. At face value, both tools assess similar components of the guideline development process, which are considered indicators for quality.…”

Section: Methodsmentioning

confidence: 99%

Guidance we can trust? The status and quality of prehospital clinical guidance in sub-Saharan Africa: A scoping review

Malherbe

Smit

Sharma

et al. 2021

African Journal of Emergency Medicine

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Introduction Prehospital care is integral in addressing sub-Saharan Africa's (SSA) high injury and illness burden. Consequently, robust, high-quality prehospital guidance documents are needed to inform care. These guidance documents include, but are not limited to, clinical practice guidelines (CPGs), protocols and algorithms that are contextually appropriate for SSA. However, SSA prehospital guidance mostly originates from the ‘Global North,’ with limited guidance for Africa by Africans. To strengthen prehospital clinical practice in SSA, we described and appraised all prehospital SSA guidance documents informing clinical decision making. Methods We conducted a scoping review of prehospital-relevant guidance documents, including CPGs, algorithms, protocols and position statements originating from SSA. We performed a comprehensive literature search in various databases (PUBMED and SCOPUS), guideline clearing houses (Scottish Intercollegiate Guidelines Network, Trip, and Guidelines International Network), journals, various forms of grey literature and contacted experts. Guidance document screening and data extraction was done independently, in duplicate and reviewed by a third author. Guidance quality was then determined using the AGREE II tool and data were analysed using simple descriptive statistics. Results We included 51 guidance documents from 13 countries across SSA after screening 2320 potential documents. The majority of guidance documents lacked an evidence foundation, made recommendations based on expert input, and were predominantly end-user presentations such as algorithms or protocols. Overall, reporting quality was poor, specifically for critical domains such as rigour of development; however, clarity of presentation was generally strong. Guidance topics were focused around resuscitation and common diseases (both communicable and non-communicable) with major gaps identified across a variety of topics; such as mental health for example. Conclusion The majority of prehospital clinical guidance from SSA provides clinicians with excellent ready to use end-user material. Conversely, most of the guidance documents lack an appropriate evidence foundation and fail to transparently report the guidance development process, highlighting the need to strengthen and build guideline development capacity to promote the transition from eminence-based to evidence-based guidance for prehospital care in SSA. Guideline developers, professional societies and publishers need to be aware of international and local guidance document development and reporting standards in order to produce guidance we can trust.

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Section: Methodsmentioning

confidence: 99%

Guidance we can trust? The status and quality of prehospital clinical guidance in sub-Saharan Africa: A scoping review

Malherbe

Smit

Sharma

et al. 2021

African Journal of Emergency Medicine

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“…Guidelines are particularly vulnerable to the effects of conflicts and interests, due to stakeholder engagement being a cornerstone guideline process [30]. The guideline community is setting new quality and evidence thresholds [17]; however, in considering evidence, guideline groups must consider the appropriateness of evidence. This is especially true for CPGs using adaptation methods, where an assessment of the generalisability and acceptability of evidence to context and guidelines users is often absent in dialogue.…”

Section: Discussionmentioning

confidence: 99%

“…Most examples of alternative guideline development methods in prehospital care use a hybrid combination of synthesising primary evidence (de novo methods) and adaptation methods [12]. Globally, these methods are poorly described, which is not surprising as quality reporting criteria for alternative guideline development methods do not exist, although work is in progress [17]. Even AGREE II, a guideline quality appraisal tool, does not make provision for adapted CPG methods [3].…”

Section: Introductionmentioning

confidence: 99%

Strengthening prehospital clinical practice guideline implementation in South Africa: a qualitative case study

McCaul

Young

Bruijns

et al. 2020

BMC Health Serv Res

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Background: Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, research into alternative methods of CPG development using existing CPG documents (CPG adaptation)a specific issue for guideline development groups in low-and middle-income countriesis sparse. There are only a few examples showcasing the pragmatic application of such alternative approaches in settings with time and budget constraints, especially in the prehospital setting. This paper aims to describe and strengthen the methods of developing prehospital CPGs using alternative guideline development methods through a case study design. Methods: We qualitatively explored a CPG development project conducted in 2016 for prehospital providers in South Africa as a case study. Key stakeholders, involved in various processes of the guideline project, were purposefully sampled. Data were collected from one focus group and six in-depth interviews and analysed using thematic analysis. Overarching themes and sub-themes were inductively developed and categorised as challenges and recommendations and further transformed into action points. Results: Key challenges revolved around guideline implementation as opposed to development. These included the unavoidable effect of interest and beliefs on implementing recommendations, the local evidence void, a shifting implementation context, and opposing end-user needs. Guideline development and implementation strengthening priority actions included: i) developing a national end-user document; ii) aligning recommendations with local practice; iii) communicating a clear and consistent message; iv) addressing controversial recommendations; v) managing the impact of interests, beliefs and intellectual conflicts; and vi) transparently reporting implementation decisions. Conclusion: The cornerstone of a successful guideline development process is the translation and implementation of CPG recommendations into clinical practice. We highlight key priority actions for prehospital guideline development teams with limited resources to strengthen guideline development, dissemination, and implementation by drawing from lessons learnt from a prehospital guideline project conducted in South Africa.

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“…Despite the fact that these tools were designed more towards de-novo developed CPGs, rather than adapted CPGs, we will report our adapted CPG for ADHD using the AGREE II reporting checklist after applying speci c explanations to the items of the checklist relevant to our CPG adaptation process in contrast to a CPG development process (Additional File). Furthermore, there is an ongoing research project for developing an extension of the RIGHT statement for the reporting of 'adapted CPGs' (RIGHT-Ad@pt Checklist) [18].…”

Section: Guideline Adaptation Methodologymentioning

confidence: 99%

Adapting evidence-based clinical practice guidelines for people with attention deficit hyperactivity disorder in Saudi Arabia: process and outputs of a national initiative

Bashiri

Albatti

Hamad

et al. 2020

Preprint

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Abstract Background: We recently adapted the published National institute for Health and Care Excellence (NICE) Attention deficit hyperactivity disorder (ADHD) diagnosis and management guideline to the Saudi Arabian context. It has been postulated that adaptation of evidence-based clinical practice guidelines to the local healthcare context rather than de-novo development will improve their adoption and implementation without imposing a significant burden on resources. The objective of this paper is to describe the adaptation process methodology utilized for the generation of the first national guideline for management of people with ADHD in Saudi Arabia.Methods: We used the KSU-Modified-ADAPTE methodology for the guideline adaptation process. We describe the full process in detail including the three phases of set-up, adaptation, and finalization. The process was conducted by a multidisciplinary guideline adaptation group in addition to an external review for the clinical content and methodology.Results: The group adapted ten main categories of recommendations from one source CPG (NICE). The recommendations include; (i) service organisation and training, (ii) recognition, identification and referral, (iii) diagnosis, (iv) support, (v) managing ADHD, (vi) dietary advice, (vii) medication, (viii) maintenance and monitoring, (ix) adherence to treatment, and (x) review of medication and discontinuation. Several implementation tools were compiled and developed to enhance implementability including a clinical algorithm, quality measures, coding system, medication tables, translations, patient information, and online resources.Conclusions: The finalized clinical practice guideline provides healthcare providers with applicable evidence-based guidance for the management of people with ADHD in Saudi Arabia. The project also demonstrated the effectiveness of KSU-Modified-ADAPTE, and emphasized the value of a collaborative clinical and methodological expert group for adaptation of national guidelines.

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Extending the RIGHT statement for reporting adapted practice guidelines in healthcare: the RIGHT-Ad@pt Checklist protocol

Cited by 21 publications

References 41 publications

Guidance we can trust? The status and quality of prehospital clinical guidance in sub-Saharan Africa: A scoping review

Guidance we can trust? The status and quality of prehospital clinical guidance in sub-Saharan Africa: A scoping review

Strengthening prehospital clinical practice guideline implementation in South Africa: a qualitative case study

Adapting evidence-based clinical practice guidelines for people with attention deficit hyperactivity disorder in Saudi Arabia: process and outputs of a national initiative

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