GRADE guidance 39: using GRADE-ADOLOPMENT to adopt, adapt or create contextualized recommendations from source...

Area of Science:

• Health policy and guideline development
• Evidence synthesis and appraisal
• Clinical decision-making

Background:

• The Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-ADOLOPMENT methodology is established for adapting or creating guidelines.
• Previous applications highlighted the need for refined operational guidance.

Purpose of the Study:

• To update and operationalize the GRADE-ADOLOPMENT methodology for applying recommendations.
• To provide clear pathways for guideline adaptation and development.

Main Methods:

• Iterative drafting of guidance through group discussions and communications.
• Review of guideline handbooks and scoping review of adolopment projects.
• Refinement of the approach based on feedback and case study examples.

Main Results:

• The updated guidance details alternative pathways for initiating adolopment efforts.
• It elaborates on essential steps, including leveraging or developing evidence-to-decision (EtD) criteria.
• Examples from case studies illustrate the application of contextual evidence for EtD judgments.

Conclusions:

• The revised GRADE-ADOLOPMENT guidance enhances the practical application of the methodology.
• It supports users in contextualizing recommendations efficiently for local settings or resource constraints.
• Over six years of experience inform this updated operational framework.