Adaptation Frameworks for Clinical Guidelines and Proposing a Framework for Iran: A Review and Comparative Study.

Area of Science:

• Health Services Research
• Evidence-Based Medicine
• Guideline Adaptation

Background:

• Clinical Practice Guidelines (CPGs) require adaptation to local contexts to optimize resource use and ensure relevance.
• Adaptation involves maintaining evidence-based principles while integrating patient conditions, cultural norms, and health system specifics.
• Existing adaptation frameworks vary, necessitating a comparative analysis to develop a refined approach.

Purpose of the Study:

• To systematically describe, interpret, and compare existing frameworks for adapting clinical practice guidelines.
• To propose a comprehensive, ten-step framework for adapting clinical guidelines tailored for Iran.
• To provide a replicable model for guideline adaptation in diverse healthcare settings.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Scopus, Trip Database, Science Direct, Google Scholar) to identify adaptation frameworks.
• Nine relevant frameworks were selected based on inclusion/exclusion criteria for detailed description, interpretation, and comparative analysis.
• A panel of experts was consulted to refine and finalize the proposed comprehensive adaptation framework.

Main Results:

• The literature search identified 26 potential frameworks, with nine meeting the study's inclusion criteria.
• A comparative analysis of the nine frameworks was performed, highlighting their strengths and weaknesses.
• A ten-step comprehensive framework for clinical guideline adaptation was developed and proposed.

Conclusions:

• The proposed ten-step framework offers a structured approach for adapting clinical practice guidelines, particularly relevant for the Iranian context.
• This framework can serve as a valuable tool for other countries seeking to implement evidence-based guidelines effectively.
• Further validation through case studies and expert consultation is recommended to assess the framework's practical application and generalizability.