Adapting the ADAPTE framework for Traditional Chinese Medicine clinical practice guidelines: a methodological study

Area of Science:

• Integrative Medicine
• Evidence-Based Practice
• Healthcare Adaptation Methodologies

Background:

• Standardizing healthcare requires adapting clinical practice guidelines (CPGs).
• Existing adaptation frameworks, like ADAPTE, are not tailored for Traditional Chinese Medicine (TCM) due to fundamental differences in medical principles.
• This incompatibility hinders the development of standardized TCM care.

Purpose of the Study:

• To modify the ADAPTE process for the specific needs of Traditional Chinese Medicine (TCM).
• To develop a rigorous and culturally sensitive framework for adapting TCM clinical practice guidelines (TCM CPGs).
• To bridge the gap in existing methodologies for TCM CPG adaptation.

Main Methods:

• A dual-tiered working group (core team and expert panel) simulated the original ADAPTE process on TCM CPGs.
• Identified challenges related to TCM diagnostic frameworks and holistic treatment paradigms.
• Revised the ADAPTE process based on expert evaluation and consensus, resulting in the ADAPTE-TCM framework with 20 modified steps and TCM-specific criteria.

Main Results:

• The initial ADAPTE-TCM framework was developed through simulated testing and expert feedback.
• High consensus was achieved among 21 experts evaluating the initial ADAPTE-TCM version.
• Significant modifications were made to 20 steps, incorporating TCM-specific evaluation criteria and tools.

Conclusions:

• The ADAPTE-TCM framework offers a methodologically rigorous approach for adapting TCM CPGs.
• This adaptation enhances the standardization of TCM care while respecting its unique medical traditions.
• The developed framework serves as a model for evolving evidence-based methodologies to accommodate diverse medical systems.