Jazayeri Seyed Behnam, Maroufi Seyed Farzad, Ghodsi Zahra, Ghawami Heshmatollah, Pourrashidi Ahmad, Amirjamshidi Abbas, Mojtahedzadeh Mojtaba, Arabkheradmand Jalil, Farahbakhsh Farzin, Shabany Maryam, Faghih-Jouibari Morteza, Fehlings Michael G, Kwon Brian K, Harrop James S, Rahimi-Movaghar Vafa
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2022 Jun 1;25(6):353-359. doi: 10.34172/aim.2022.58.
Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the dependence of patients' outcomes on the ability and knowledge of "individual" health care providers and reduces unwarranted variation in care. The aim of this study was to adapt/adopt two CPGs for pharmacologic management of acute spinal cord injury (SCI) using guideline adaptation methods.
This study was conducted based on the ADAPTE process. Following establishment of an organizing committee and choosing the health topics, we appraised the quality of the CPGs using the Appraisal of Clinical Guidelines for Research & Evaluation II (AGREE II). Then, the authors extracted and categorized suggestions according to Population, Intervention, Professions, Outcomes and Health care setting (PIPOH). The decision-making process was based on systemic evaluation of each suggestion, utilizing a combination of AGREE II scores, the quality of supporting evidence for or against each suggestion and the triad of feasibility, acceptance and adoptability for the Iranian health-care context.
Two guidelines were included in the adaptation process. Based on high-quality of these guidelines and the feasibility and adoptability evaluation of the organizing committee, we decided to adopt the suggestion of both guidelines. Overall, seven suggestions were extracted from the source guidelines.
This work provides a framework to apply guidelines for acute SCI to the developing regions of the world. Attempts should be made to implement these suggestions in order to improve the health outcomes of Iranian SCI patients.
合理运用高质量的临床实践指南（CPG）可消除患者治疗结果对“个体”医疗服务提供者能力和知识的依赖，并减少不必要的护理差异。本研究的目的是使用指南改编方法改编/采用两项关于急性脊髓损伤（SCI）药物治疗的CPG。
本研究基于ADAPTE流程进行。在成立组织委员会并选定健康主题后，我们使用《研究与评价临床指南评估II》（AGREE II）对CPG的质量进行了评估。然后，作者根据人群、干预措施、专业人员、结果和医疗保健环境（PIPOH）对建议进行了提取和分类。决策过程基于对每条建议的系统评估，综合考虑AGREE II评分、支持或反对每条建议的证据质量以及伊朗医疗保健背景下的可行性、可接受性和适用性。
两项指南被纳入改编过程。基于这些指南的高质量以及组织委员会的可行性和适用性评估，我们决定采纳两项指南的建议。总体而言，从原始指南中提取了七条建议。
本研究为将急性SCI指南应用于世界发展中地区提供了一个框架。应努力实施这些建议，以改善伊朗SCI患者的健康结局。
