[Three ways to develop clinical guidelines. ADAPTE and AGREE GRS procedures]

Area of Science:

• Health Services Research
• Medical Informatics
• Evidence-Based Medicine

Background:

• Developing de novo clinical guidelines (CG) is resource-intensive, requiring significant time, expertise, and funding.
• Limited resources in many countries necessitate alternative approaches to CG development.
• Adoption and adaptation are established methods for creating localized CG.

Purpose of the Study:

• To explore alternative strategies for clinical guideline development.
• To compare the resource implications and methodologies of CG adoption and adaptation.
• To highlight the benefits of adaptation for promoting evidence-based medicine.

Main Methods:

• Review of existing methodologies for clinical guideline development, specifically adoption and adaptation.
• Discussion of the ADAPTE procedure for guideline adaptation.
• Mention of assessment tools like AGREE II and AGREE GRS for evaluating methodological quality.

Main Results:

• Adoption involves direct translation of foreign CG, being the simplest method.
• Adaptation modifies existing CG to suit local healthcare contexts, a more complex process.
• Adaptation, while more demanding than adoption, offers a balance between resource saving and promoting evidence-based medicine.

Conclusions:

• De novo CG development is often unnecessary and costly given information exchange.
• Adoption is preferable in resource-scarce settings.
• Adaptation provides a valuable compromise, saving resources and advancing evidence-based medicine practices.