Moradi-Joo Mohammad, Olyaeemanesh Alireza, Akbari-Sari Ali, Rayegani Seyed Mansoor
Department of Health Management & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2022 Feb 16;36:10. doi: 10.47176/mjiri.36.10. eCollection 2022.
Clinical Practice Guidelines (CPGs) can be adapted to local conditions to prevent any resources from being wasted. Adaptation of CPGs implies a systematic view of developed guidelines through maintaining evidence-based principles in order to find the ones most relevant with patients' conditions and its integration with the cultural and regional requirements of the target population and health system facilities. The main purpose of the study was to describe, interpret and compare different frameworks for adaptation of clinical guidelines and proposing a comprehensive framework for Iran. This study was based on a review and comparative analysis of adaptation frameworks of CPGs. Initially, all adaptation frameworks were collected by systematic search in the literature. We searched the following electronic databases: PubMed, Scopus, Trip Database, Science Direct, and Google Scholar. Then, based on the stages of the comparative study, frameworks were described, interpreted, juxtaposed, and compared. Finally, a comprehensive framework for the adaptation of clinical guidelines was proposed by consulting a panel of experts. Our literature search resulted in 26 frameworks, of which 18 were potentially relevant. Based on inclusion/exclusion criteria, nine frameworks were included in the study and have been described, interpreted, and compared. The proposed comprehensive framework for the adaptation of clinical guidelines consists of ten main steps. The proposed comprehensive framework is an appropriate tool for the adaptation of clinical guidelines in Iran that can be used in other countries. However, further validation of the framework requires case studies and expert consultation to determine its application to the adaptation of clinical guidelines.
临床实践指南（CPGs）可因地制宜进行调整，以避免任何资源浪费。CPGs的调整意味着通过坚持循证原则，对已制定的指南进行系统审视，从而找出与患者病情最相关的指南，并使其与目标人群的文化和地区需求以及卫生系统设施相结合。本研究的主要目的是描述、阐释并比较临床指南调整的不同框架，并为伊朗提出一个综合框架。 本研究基于对CPGs调整框架的综述和比较分析。最初，通过对文献进行系统检索收集所有调整框架。我们检索了以下电子数据库：PubMed、Scopus、Trip数据库、ScienceDirect和谷歌学术。然后，根据比较研究的阶段，对框架进行描述、阐释、并列和比较。最后，通过咨询专家小组，提出了临床指南调整的综合框架。 我们的文献检索得到了26个框架，其中18个可能相关。根据纳入/排除标准，9个框架被纳入研究，并已进行描述、阐释和比较。所提出的临床指南调整综合框架包括十个主要步骤。 所提出的综合框架是伊朗调整临床指南的合适工具，也可在其他国家使用。然而，该框架的进一步验证需要进行案例研究和专家咨询，以确定其在临床指南调整中的应用情况。
