Article type
Abstract
Background
The Global Evidence, Local Adaptation (GELA) project aims to use global research to develop evidence-informed, locally relevant guideline recommendations for newborn and child health in Malawi, Nigeria, and South Africa, underpinned by GRADE-ADOLOPMENT. To improve efficiency and reduce research waste, guideline questions from country-level stakeholder priority-setting required the identification of appropriate source guidelines and recommendations to potentially adopt or adapt.
Objective
To describe, for 4 prioritized guideline questions, approaches and learnings from scoping to identify appropriate source guidelines, with the intention of adopting or adapting a recommendation for country-level guideline development.
Methods
A generic GELA guideline scoping protocol was implemented separately for each question by country-level teams comprising experienced and novice members. We used question-specific strategies to search generic and topic-specific guideline sources. Title, abstract, and table of contents screening were conducted at the guideline level. Full-text guidelines were then evaluated, assessing recommendations for relevancy to the priority guideline question. Thereafter, guidelines containing a matching recommendation were appraised for recency, credibility (AGREE 2), and path to recommendation (evidence-to-decision [EtD] frameworks, evidence profiles, synthesized evidence around EtD criteria).
Results
Scoping for source guidelines was time-intensive and presented unforeseen complexities related to question and contextual clarity. Across 4 questions, we screened n = 936 guidelines and found n = 55 potentially eligible; n = 4 contained matching recommendations and were further appraised. For 2 questions, we found source guidelines with EtD frameworks for matching recommendations. Across EtD criteria, completeness of information varied. Where evidence syntheses were available for EtD criteria, these had limitations. A guideline with a matching recommendation for the third question had no clear path to recommendation; no source guideline was found for the fourth. Successful navigation of complexities required dedicated experiential learning sessions, iterative team discussions, and multiple careful decisions led by experienced reviewers.
Conclusions
More efficient scoping to identify source guidelines with matching recommendations for adolopment requires careful consideration of setting and capacity factors, understanding the nuances required for this purposive guideline scoping, and starting with clear, well-framed questions.
Patient, Public, and/or Health Care Consumer Relevance
Consumer representatives were involved in guideline topic prioritization. Evidence-informed guidelines impact practices and policies affecting outcomes in all groups.
The Global Evidence, Local Adaptation (GELA) project aims to use global research to develop evidence-informed, locally relevant guideline recommendations for newborn and child health in Malawi, Nigeria, and South Africa, underpinned by GRADE-ADOLOPMENT. To improve efficiency and reduce research waste, guideline questions from country-level stakeholder priority-setting required the identification of appropriate source guidelines and recommendations to potentially adopt or adapt.
Objective
To describe, for 4 prioritized guideline questions, approaches and learnings from scoping to identify appropriate source guidelines, with the intention of adopting or adapting a recommendation for country-level guideline development.
Methods
A generic GELA guideline scoping protocol was implemented separately for each question by country-level teams comprising experienced and novice members. We used question-specific strategies to search generic and topic-specific guideline sources. Title, abstract, and table of contents screening were conducted at the guideline level. Full-text guidelines were then evaluated, assessing recommendations for relevancy to the priority guideline question. Thereafter, guidelines containing a matching recommendation were appraised for recency, credibility (AGREE 2), and path to recommendation (evidence-to-decision [EtD] frameworks, evidence profiles, synthesized evidence around EtD criteria).
Results
Scoping for source guidelines was time-intensive and presented unforeseen complexities related to question and contextual clarity. Across 4 questions, we screened n = 936 guidelines and found n = 55 potentially eligible; n = 4 contained matching recommendations and were further appraised. For 2 questions, we found source guidelines with EtD frameworks for matching recommendations. Across EtD criteria, completeness of information varied. Where evidence syntheses were available for EtD criteria, these had limitations. A guideline with a matching recommendation for the third question had no clear path to recommendation; no source guideline was found for the fourth. Successful navigation of complexities required dedicated experiential learning sessions, iterative team discussions, and multiple careful decisions led by experienced reviewers.
Conclusions
More efficient scoping to identify source guidelines with matching recommendations for adolopment requires careful consideration of setting and capacity factors, understanding the nuances required for this purposive guideline scoping, and starting with clear, well-framed questions.
Patient, Public, and/or Health Care Consumer Relevance
Consumer representatives were involved in guideline topic prioritization. Evidence-informed guidelines impact practices and policies affecting outcomes in all groups.