Using the GRADE-ADOLOPMENT framework in developing the Philippine national screening guideline recommendations

Preventive health screening is an important strategy in improving health outcomes of the general population and sustaining universal healthcare initiatives. Due to the large resource requirement, we used the GRADE ADOLOPMENT framework to synthesize the evidence and develop recommendations for preventive health screening.

Our objectives were to describe the development and feasibility of a national preventive screening practice guideline using the GRADE-adolopment process and to discuss the methodological process, contextual differences from the source guidelines, and the resulting changes to the final recommendations.

A multidisciplinary team was convened. We used the GRADE-ADOLOPMENT and Evidence-to-Decision (EtD) framework in synthesizing the evidence and developing the recommendations. Evidence from the World Health Organization, United States Preventive Services Task Force, and Canadian Task Force on Preventive Healthcare were used. Values and preferences of the guideline developers were incorporated through the EtD framework.

In 6 months, we developed 16 evidence summaries and developed 23 recommendations for 16 prioritized conditions. Thirteen recommendations were adopted. Four recommendations were modified to address contextual differences. Six recommendations were developed de novo due to either lack of evidence or differences in values and preferences.

The GRADE-adolopment framework was a feasible and efficient framework in adopting guidelines on preventive screening. The EtD framework improved the transparency and highlighted areas to consider in making recommendations for the Philippine context. Challenges encountered were insufficiency of local evidence, and the lack of experience and skills in interpreting and analyzing the evidence especially on screening strategies.