[Not Available]

Preparing clinical practice guidelines (CPG) is an expensive process requiring a great deal of time and the participation of numerous professionals with knowledge of methodology. But the use of higher-quality CPGs could make this process easier. The aim of this work was to evaluate the application of a composite development-adaptation-updating method for the development of the asthma CPG in the Basque Country Autonomous Community.

A four step process was followed: a) Drawing up of clinical questions and searching for CPGs and Cochrane reviews; b) Guidelines evaluation using the AGREE tool; c) Analysis of the clinical content using the "Table of Guidelines", and d) Application of 7 criteria to evaluate whether guidelines and Cochrane reviews adequately resolved each question. Obtained results determined the applied strategy: de novo development, partial development (abbreviated search and evaluation) or adoption of guidelines and/or Cochrane reviews recommendations.

Twenty nine questions were formulated and 7 CPGs were selected. Out of the total questions, 86.2% were covered by guidelines while 37.9% by Cochrane reviews. Consistency rate was high, up to 53.6%. Updating was required in 75%. Of the recommendations, 46.4% were strongly graded and 39.3% by consensus. The strategy followed was of partial development in 62.1%, "de novo" in 13.8% and adoption of guidelines/Cochrane reviews in 24.1%. Statistically significant differences were observed in the previous criteria according to the type of question (diagnosis, treatment, education, prevention).

Despite the availability of high-quality guidelines, many questions required partial development. However, this study provides a number of key aspects for future guideline development/ adaptationprojects.