From: The advantages and limitations of guideline adaptation frameworks
Framework (year published) Author(s) (framework development group) | Committee structure | Methods and process summary | Updating of the adapted guideline | How adapted recommendations were constructed (e.g., consultation, consensus, EtD tables) | External peer review | Presentation and dissemination of the adapted guideline |
---|---|---|---|---|---|---|
Practice guideline evaluation and adaptation cycle (2005) [36] Graham, I. D. Harrison, M. B. | A single local interdisciplinary20 guideline evaluation group comprising key stakeholders | • Identify a clinical area to promote best practice, • Search and evaluate existing guidelines, • Adopt or adapt the guideline for local use | Yes | Consensus in the guideline evaluation group | Yes, by local practitioners, other stakeholders, and organizational policy-makers for review and comment | Unclear, likely hardcopy documents |
Systematic guideline review (2009) [37] Muth, C. et al. (“Kompetenznetz Herzinsuffizienz” and the German Society for General Practice and Family Medicine (DEGAM)) | Most steps conducted by the 5 authors | • Use multiple sources to search for guidelines • Assess quality of the guidelines • Collate recommendations from different guidelines into “evidence tables of a standardized format which included recommendation(s), evidence level(s), grading, critical appraisal of evidence, and cited sources” | No | Consensus by the authors | Yes, a multi-professional, interdisciplinary formal consensus process that included a patients’ representative and a pilot testing phase | Hardcopy documents |
ADAPTE (2011) [16] ADAPTE Collaboration (including Graham, I. D. Harrison, M. B.) | Dual committee structure consisting of the organizing committee and panel of guideline developers (usually content experts) | • Search for source guidelines • Assess source guidelines • Adapt source guideline | Yes | Consensus by the panel | Yes, by target users, consulted with relevant endorsement bodies and the developers of source guidelines | Hardcopy documents |
The Alberta Ambassador Program (AAP) adaptation process (2011) [26] Harstall, C. et al. (The Alberta Ambassador Program) | Up to 6 committees with distinct responsibilities in the adaptation process | • Formulate the question from knowledge gaps in the adaptation context • Literature search to identify relevant source guidelines. • Assess source guidelines • Adapt guideline written via monthly videoconferences of the Guideline Development Group | Yes “living” guideline that will be updated every 2 years | Consensus by the guideline development group | Yes, by clinical experts, methodologists, and potential guideline users who were not involved in its development | Targeted to local implementation facilitators. Including internet access to the guidelines |
Harrison, M. B. Graham, I. D. et al. (The Canadian Partnership Against Cancer) | 2 or more committees including a steering committee and working panel(s) | • Similar steps to ADAPT • Some steps of the adaptation process done simultaneously by different sub-committees of the guideline development group. • A stronger focus on the implementation of guidelines after their adaptation | Yes | Consensus by the panel | Yes, by each stakeholder group affected by the recommendations | Adaptation only the first phase of the CAN-IMPLEMENT process. Phase 2 is development of training programs and interventions to implement new guideline. Phase 3 involves evaluation of the process and outcomes |
SNAP-IT by GRADE (2014) [28] Kristiansen, A. et al. (Canadian McMaster University GRADE group partnership with Norwegian Ministry of health) | Editorial committee, individual chapter editors | • Select one well established guideline which was deemed to be current, of high quality, and used GRADE (23) • Choose recommendations within this guideline that they deem relevant in the adaption context to adopt/adapt | Dynamically update the recommendations at least every 3 months | One content expert and one methods expert on the editorial committee reviewed each chapter of the guideline to choose which recommendations to adopt and/adapt. The panel consulted with editors of the source guideline on content issues and when modifications were made. | Yes, by all relevant medical specialty organizations, local ministry of health and the source guideline development organization | Published in newly developed web authoring and publication platform (MAGIC), including offline access on smartphones and tablets |
Adapted ADAPTE (2015) [32] Amer, Y. S. Elzalabany, M. M. Omar, T. I. Ibrahim, A. G. Dowidar, N. L. | Dual committee structure consisting of the organizing committee and panel | Framework based on the work of ADAPTE collaboration and CAN-IMPLEMENT with modifications to increase the timeliness and clarity of the adaptation process | Yes | Consensus by the panel | Yes, same as ADAPTE | Hardcopy documents. The framework include some implementation tools which include professional and organizational interventions, monitoring and evaluation, and an action plan for dissemination |
GRADE-ADOLOPMENT (2017) [19] Schunemann, H. J et al. (Canadian McMaster University GRADE group partnership with Saudi Arabian Ministry of health) | Methodologist group from McMaster university. Guideline panels made up of local expert members from multidisciplinary backgrounds, including some patient representatives | • Local authorities choose the key clinical questions; • Identify specific recommendations that address those questions. • Choose source guidelines based on the GRADE approach and constructing EtD tables • Revise and update these tables are to match the local context. | N/A This framework stops at the decision to either adopt, adapt the source recommendation/evidence, or start de novo development of a new guideline. | Evidence to decision (EtD) tables | N/A This framework stops at the decision to adopt, adapt the source recommendation/evidence or start de novo development of a new guideline. | Unclear, in the case described the adapted guidelines were made for the Kingdom of Saudi Arabia and dissemination was the responsibility of the local government |