Article type
Year
Abstract
Background: Adaptation of health practice guidelines to local settings is expected to improve their uptake and implementation. One challenge of adapting guidelines is to keep them efficient while ensuring they are evidence based.
Objective: To showcase the advantage of published systematic reviews (SRs) to increase the efficiency of the process of adaptation of health practice guidelines.
Methods: We are using the GRADE-Adolopment methodology to adapt the recently published American College of Rheumatology (ACR) Rheumatoid Arthritis (RA) guidelines to the Eastern Mediterranean region. The methodology builds on the advantages of adaptation, adoption, and de novo guideline development. We searched for published SRs on the topic of interest. Our next task was to select SRs that would contribute to evidence to support the guideline recommendations.
Results: In the context of adapting the ACR RA guidelines, the following three characteristics of published SRs were important when evaluating their potential use: relevance, quality and 'up-to-date-ness'. First, we assess the relevance of identified SRs by matching their PICO to that of the guideline questions. The minimum requirement is for the population, intervention and control elements to match to a reasonable degree, i.e. not to have serious indirectness for more than one of the three elements. Then, we assess the quality of relevant SRs using the AGREE (Appraisal of Guidelines for Research and Evaluation) instrument. If we identify more than one SR, we prioritize the one with the highest quality. Finally, we assess the up-to-date-ness of the SR judged to be relevant and of highest quality; if it is not up to date, we proceed with updating it. At the Colloquium, we will present the descriptive statistics relating to the number of guideline questions, the number of SRs identified, how many were considered relevant and of high quality. Also we will provide data on how many SRs required updating.
Conclusion: Guideline groups considering the use of published SR need to assess their relevance, quality and up-to-date-ness as a way to ensure the process is efficient and the guideline is evidence based.
Objective: To showcase the advantage of published systematic reviews (SRs) to increase the efficiency of the process of adaptation of health practice guidelines.
Methods: We are using the GRADE-Adolopment methodology to adapt the recently published American College of Rheumatology (ACR) Rheumatoid Arthritis (RA) guidelines to the Eastern Mediterranean region. The methodology builds on the advantages of adaptation, adoption, and de novo guideline development. We searched for published SRs on the topic of interest. Our next task was to select SRs that would contribute to evidence to support the guideline recommendations.
Results: In the context of adapting the ACR RA guidelines, the following three characteristics of published SRs were important when evaluating their potential use: relevance, quality and 'up-to-date-ness'. First, we assess the relevance of identified SRs by matching their PICO to that of the guideline questions. The minimum requirement is for the population, intervention and control elements to match to a reasonable degree, i.e. not to have serious indirectness for more than one of the three elements. Then, we assess the quality of relevant SRs using the AGREE (Appraisal of Guidelines for Research and Evaluation) instrument. If we identify more than one SR, we prioritize the one with the highest quality. Finally, we assess the up-to-date-ness of the SR judged to be relevant and of highest quality; if it is not up to date, we proceed with updating it. At the Colloquium, we will present the descriptive statistics relating to the number of guideline questions, the number of SRs identified, how many were considered relevant and of high quality. Also we will provide data on how many SRs required updating.
Conclusion: Guideline groups considering the use of published SR need to assess their relevance, quality and up-to-date-ness as a way to ensure the process is efficient and the guideline is evidence based.