Methods used in adaptation of health–related guidelines: A systematic survey

Abstract

BackgroundAdaptation 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.ObjectiveTo 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.MethodsWe searched Medline and Embase up to June 2015. We assessed the method of adaptation, and the quality of included guidelines.ResultsSeventy–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 adapted guidelines was highest for the “scope and purpose” domain and lowest for the “editorial independence” domain (respective mean percentages of the maximum possible scores were 93% and 43%). The mean score for “rigor of development” was 57%.ConclusionMost adapted guidelines published in peer–reviewed journals do not report using a published adaptation method, and their adaptation quality was variable.

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

“…Building on work done for WHO in 2006, the ‘GRADE-ADOLOPMENT’ framework proposed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision frameworks for the adaptation, adoption and de novo development of guidelines 16. Despite these advances, there is variability in the quality of reporting of adapted practice guidelines and no guidance for their reporting is available 23 25. The proposed checklist might help with reducing the variability of adaptation process and improving the quality of reporting.…”

“…To develop the checklist, we will build on the RIGHT statement,29 review methodology research evidence on guidelines adaptation23–25 and adopt a multistep process we have successfully implemented in the development of similar tools 31 32Table 1 describes the multistep development process of the RIGHT-Ad@pt Checklist, which includes: (1) establishment of a Working Group; (2) generation of an initial checklist; (3) optimisation of the checklist (an initial assessment of adapted guidelines, semistructured interviews, a Delphi consensus survey, an external review by guideline developers and users and a final assessment of adapted guidelines); and (4) approval of the final checklist.…”

“…We will aim for country income, gender and profile representativeness of participants. We will identify participants from the Guidelines International Network (GIN) Adaptation Guidelines Working Group (http://www.g-i-n.net/working-groups/adaptation), WHO, authors of adapted guidelines25 and expert colleagues. The panel’s CoIs will be collected.…”

“…Out of 170 eligible adapted guidelines, only 32 (32/170, 19%) reported the methods used in the adaptation process 24. Similarly, Abdul-Khalek et al assessed the methods used for adapting health-related guidelines published in peer-reviewed journals 25. Out of the 72 included adapted guidelines, 57 reported some degree of detail about the adaptation method used, and only 23 (23/57, 40%) reported using a specific adaptation method.…”

Mapping the nomenclature, methodology, and reporting of studies that review methods: a pilot methodological review

“…Many of the authors were from Canadian institutions (n = 12, 38.7%), followed by Japan and USA (n = 4, 12.9% each). Based on the previously defined criteria, we scored ten studies (32.3%) as generalizable [28,30,38,40,49,[51][52][53][54]57]. Only three studies (9.7%, two of which we scored as generalizable) commented on generalizability and reported their own work as generalizable, either to the subject area (e.g., venous ulcer disease), to a clinical area, or in general terms [27,30,38].…”