Darzi Andrea, Abou-Jaoude Elias A, Agarwal Arnav, Lakis Chantal, Wiercioch Wojtek, Santesso Nancy, Brax Hneine, El-Jardali Fadi, Schünemann Holger J, Akl Elie A
AUB GRADE Center, Clinical Research Institute, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon; Systematic Reviews of Health Policy and Systems Research (SPARK), American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon.
School of Business, Canisius College, 2001 Main Street, Buffalo, NY 14208, USA.
J Clin Epidemiol. 2017 Jun;86:3-10. doi: 10.1016/j.jclinepi.2017.01.016. Epub 2017 Apr 13.
Our objective was to identify and describe published frameworks for adaptation of clinical, public health, and health services guidelines.
We included reports describing methods of adaptation of guidelines in sufficient detail to allow its reproducibility. We searched Medline and EMBASE databases. We also searched personal files, as well manuals and handbooks of organizations and professional societies that proposed methods of adaptation and adoption of guidelines. We followed standard systematic review methodology.
Our search captured 12,021 citations, out of which we identified eight proposed methods of guidelines adaptation: ADAPTE, Adapted ADAPTE, Alberta Ambassador Program adaptation phase, GRADE-ADOLOPMENT, MAGIC, RAPADAPTE, Royal College of Nursing (RCN), and Systematic Guideline Review (SGR). The ADAPTE framework consists of a 24-step process to adapt guidelines to a local context taking into consideration the needs, priorities, legislation, policies, and resources. The Alexandria Center for Evidence-Based Clinical Practice Guidelines updated one of ADAPTE's tools, modified three tools, and added three new ones. In addition, they proposed optionally using three other tools. The Alberta Ambassador Program adaptation phase consists of 11 steps and focused on adapting good-quality guidelines for nonspecific low back pain into local context. GRADE-ADOLOPMENT is an eight-step process based on the GRADE Working Group's Evidence to Decision frameworks and applied in 22 guidelines in the context of national guideline development program. The MAGIC research program developed a five-step adaptation process, informed by ADAPTE and the GRADE approach in the context of adapting thrombosis guidelines. The RAPADAPTE framework consists of 12 steps based on ADAPTE and using synthesized evidence databases, retrospectively derived from the experience of producing a high-quality guideline for the treatment of breast cancer with limited resources in Costa Rica. The RCN outlines five key steps strategy for adaptation of guidelines to the local context. The SGR method consists of nine steps and takes into consideration both methodological gaps and context-specific normative issues in source guidelines. We identified through searching personal files two abandoned methods.
We identified and described eight proposed frameworks for the adaptation of health-related guidelines. There is a need to evaluate these different frameworks to assess rigor, efficiency, and transparency of their proposed processes.
我们的目的是识别并描述已发表的临床、公共卫生及卫生服务指南的改编框架。
我们纳入了详细描述指南改编方法以使其具有可重复性的报告。我们检索了Medline和EMBASE数据库。我们还检索了个人文件，以及提出指南改编和采用方法的组织和专业协会的手册及指南。我们遵循标准的系统评价方法。
我们的检索共获得12,021条引文，从中我们识别出8种指南改编的提议方法：ADAPTE、改编后的ADAPTE、艾伯塔大使计划改编阶段、GRADE - ADOLOPMENT、MAGIC、RAPADAPTE、皇家护理学院（RCN）以及系统指南评价（SGR）。ADAPTE框架包含一个24步的过程，该过程在考虑需求、优先事项、立法、政策和资源的情况下，使指南适应当地情况。亚历山德拉循证临床实践指南中心更新了ADAPTE的一种工具，修改了三种工具，并新增了三种工具。此外，他们提议可选择使用其他三种工具。艾伯塔大使计划改编阶段包含11个步骤，重点是将针对非特异性腰痛的高质量指南适应当地情况。GRADE - ADOLOPMENT是一个基于GRADE工作组的证据到决策框架的八步过程，在国家指南制定计划的背景下应用于22项指南。MAGIC研究计划在改编血栓形成指南的背景下，借鉴ADAPTE和GRADE方法，制定了一个五步改编过程。RAPADAPTE框架基于ADAPTE并使用综合证据数据库，由哥斯达黎加在资源有限的情况下制定高质量乳腺癌治疗指南的经验回顾性推导而来，包含12个步骤。RCN概述了将指南适应当地情况的五个关键步骤策略。SGR方法包含九个步骤，并考虑了源指南中的方法学差距和特定背景的规范性问题。通过检索个人文件，我们识别出两种已被废弃的方法。
我们识别并描述了8种提议的健康相关指南改编框架。有必要对这些不同的框架进行评估，以评估其提议过程的严谨性、效率和透明度。
