Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Neonatal Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Health Res Policy Syst. 2023 Nov 1;21(1):114. doi: 10.1186/s12961-023-01060-z.
Guideline adaptation is an emerging field to provide more appropriate recommendations for local clinical practice quality and to promote global health equity. However, its utilization status, adaptation procedures, and related materials remain to be studied.
This study developed a quality improvement protocol for a study as the Development, Evaluation, and impLemenTation for guideline Adaptation (DELTA) study. Current adapted clinical practice guidelines (CPGs) will be systematically searched. Their characteristics, utilization status, and adaptation procedures will be extracted, compared, and analyzed. Whether these adapted CPGs rigorously followed the instruments and steps of adaptation frameworks will also be appraised. In addition, the advantages and limitations of current adaptation methods and their suitable application situations will be analyzed. In addition, future perspectives as DELTA series and DELTA system, aiming for comprehensively evaluating current needs for guideline adaptation and developing a unified framework and related materials were proposed to improve the acceptability, applicability, and implementation of guideline adaptation in clinical practice. The DELTA series are divided into four phases: phase I in analyzing status, characteristics, and procedures and completeness of adapted CPGs; phase II in analyzing differences, heterogeneity, and implementation between adapted and original CPGs; and phase III in collecting, analyzing, and comparing all available adaptation materials. With these research bases, an international working group will be established in phase IV and will develop unified guideline adaptation materials after Delphi consensus, including adaptation frameworks, appraisal tools and checklists, registries, and databases.
Guideline adaptation has been advanced as an efficient way to guide local clinical practice. However, it still faces several major challenges. The proposed DELTA study, series, and system will further contribute to this emerging topic.
This study has been registered by the PROSPERO international database. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=400170 .
指南改编是一个新兴领域，旨在为当地临床实践质量提供更合适的建议，并促进全球健康公平。然而，其利用状况、改编程序和相关材料仍有待研究。
本研究制定了一项质量改进协议，作为发展、评估和实施指南改编（DELTA）研究。将系统地搜索当前改编的临床实践指南（CPGs）。提取、比较和分析它们的特征、利用状况和改编程序。还将评估这些改编后的 CPG 是否严格遵循改编框架的工具和步骤。此外，还将分析当前改编方法的优缺点及其适用情况。此外，还提出了 DELTA 系列和 DELTA 系统的未来展望，旨在全面评估当前指南改编的需求，并制定统一的框架和相关材料，以提高指南改编在临床实践中的可接受性、适用性和实施性。DELTA 系列分为四个阶段：第一阶段分析改编后的 CPG 的现状、特征、程序和完整性；第二阶段分析改编前后 CPG 的差异、异质性和实施情况；第三阶段收集、分析和比较所有可用的改编材料。在这些研究基础上，第四阶段将成立一个国际工作组，并在德尔菲共识后制定统一的指南改编材料，包括改编框架、评估工具和检查表、登记册和数据库。
指南改编已作为指导当地临床实践的有效方法得到了推进。然而，它仍然面临着几个重大挑战。拟议的 DELTA 研究、系列和系统将进一步推动这一新兴课题的发展。
本研究已在 PROSPERO 国际数据库中注册。https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=400170。
