Methods used in adaptation of health-related guidelines: A systematic survey

Abstract

Background Adaptation refers to the systematic approach for considering the endorsement or modification of recommendations produced in one setting for application in another as an alternative to de novo development.

Objective To describe and assess the methods used for adapting health–related guidelines published in peer–reviewed journals, and to assess the quality of the resulting adapted guidelines.

Methods We searched Medline and Embase up to June 2015. We assessed the method of adaptation, and the quality of included guidelines.

Results Seventy–two papers were eligible. Most adapted guidelines and their source guidelines were published by professional societies (71% and 68% respectively), and in high–income countries (83% and 85% respectively). Of the 57 adapted guidelines that reported any detail about adaptation method, 34 (60%) did not use a published adaptation method. The number (and percentage) of adapted guidelines fulfilling each of the ADAPTE steps ranged between 2 (4%) and 57 (100%). The quality of adapted guidelines was highest for the “scope and purpose” domain and lowest for the “editorial independence” domain (respective mean percentages of the maximum possible scores were 93% and 43%). The mean score for “rigor of development” was 57%.

Conclusion Most adapted guidelines published in peer–reviewed journals do not report using a published adaptation method, and their adaptation quality was variable.