Article
Novel Adaptation Process and Taxonomy for Modifying recommendations customized for GRADE Guidelines
Search Medline for
Authors
-
A. Kristiansen
- Dep. of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
-
P.O. Vandvik
- Dep. of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
-
L. Brandt
- Dep. of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
-
S. Rosenbaum
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway
-
P. Alonso-Coello
- Iberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
-
E. Akl
- Department of Medicine, State University of New York, Buffalo, USA
-
F. Spencer
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
-
G. Guyatt
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
-
I. Neumann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
-
E. Berge
- Department of Medicine, Oslo University Hospital, Oslo, Norway
| Published: | July 10, 2012 |
|---|
Outline
Text
Background: Guidelines frequently require adaptation for successful implementation at the national level. We consider the currently recommended process for adaptation (i.e. ADAPTE) to be of limited value when considering guidelines developed according to GRADE. In SNAP-IT (Smooth Norwegian Adaptation and Presentation of guidelines to Improve Thrombosis Treatment), we will perform a pilot-study of our novel adaptation process.
Objectives: To develop and evaluate a process customized for GRADE-guidelines.
Methods: Using ADAPTE as a starting point, we have developed a 5-step adaptation process and taxonomy for modification based on the GRADE methodology. 60 content experts and methodologists will perform a real life adaptation of an international guideline for publication in Norway in 2012. In parallel we will explore the feasibility of re-writing the recommendations into a new, simplified presentation format.
Results: The 5 steps include: planning, selection of topics and recommendations, guideline adaptation (adapt, modify, translate), publication and evaluation. The taxonomy requires that the guideline members state type (direction or strength) and reason for modification (modified PICO question, new studies, confidence in effect-estimates, magnitude and balance of effect estimates, values and preferences and costs). The results of this process will be quantified according to number of recommendations included, and how and why they were modified.
Discussion: Although only a pilot study, our proposed adaptation process may help to simplify future adaptation projects and thus make them more efficient while maintaining transparency and quality of content.
Implications for guideline developers: This case study will inform further development of adaptation methodology of GRADE guidelines.
