Ayhan Baser Duygu, Kahveci Rabia, Baydar Artantas Aylin, Yasar İlknur, Aksoy Hilal, Koc Esra Meltem, Kasim İsmail, Kunnamo Ilkka, Özkara Adem
Department, Kocaeli Public Health Directorate, Izmit, Turkey.
Family Medicine, TC Saglik Bakanligi Ankara Numune, Egitim ve Arastirma, Hastanesi, Ankara, Turkey.
J Eval Clin Pract. 2018 Feb;24(1):97-104. doi: 10.1111/jep.12730. Epub 2017 Apr 27.
RATIONALE, AIMS, OBJECTIVES: 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 finalizing the guidance, including pilot studies and panel but excluding translation of ADAPTE, lasted 18 months. Nine researchers were involved in the adaptation process and 15 more experts were involved in the validation panel. Following the suggestions of the research team on modifications and validation through the expert panel; 2 steps of the ADAPTE toolkit were rejected, 2 steps were accepted by modification, 7 steps were accepted by additional recommendations. In addition, 2 tools were suggested to be added to the toolkit.
This is the first study on adaptation of guidelines in Turkey. Pilot adaptation of 2 guidelines with ADAPTE revealed that ADAPTE is a useful and feasible tool in Turkish setting, but might require certain changes in recommendations and revision of tools.
原理、目的、目标：临床实践指南大多通过三种方法制定；即从头制定、采用和改编。未发表的研究和作者经验表明，土耳其的大多数指南要么是采用要么是改编。目前没有可用的本地改编工具，因此该过程不规范，而且大多数时候没有明确界定。本研究的目的是寻找国际指南改编工具，并在土耳其背景下测试其可行性，以实现开发一种独特的本地指南改编战略工具的最终目标。
本研究的方法设计包括选择一种国际临床实践指南改编工具，用选定的土耳其指南对该工具进行试点，确定该工具的可行性并探索对该工具进行改编的需求，为改编策略提出建议，并由当地专家对该过程进行验证。
从规划阶段到最终确定指南，包括试点研究和专家小组，但不包括ADAPTE的翻译，该研究持续了18个月。9名研究人员参与了改编过程，另外15名专家参与了验证小组。根据研究团队通过专家小组提出的修改和验证建议；ADAPTE工具包的2个步骤被否决，2个步骤经修改后被接受，7个步骤经额外建议后被接受。此外，建议在工具包中增加2个工具。
这是土耳其第一项关于指南改编的研究。用ADAPTE对2项指南进行试点改编表明，ADAPTE在土耳其环境中是一种有用且可行的工具，但可能需要对建议进行某些更改并对工具进行修订。
