Methods used in adaptation of health–related guidelines: A systematic survey

BACKGROUND: Adaptation refers to the systematic approach for considering the endorsement or modification of recommendations produced in one setting for application in another as an alternative to de novo development. OBJECTIVE: To describe and assess the methods used for adapting health–related guidelines published in peer–reviewed journals, and to assess the quality of the resulting adapted guidelines. METHODS: We searched Medline and Embase up to June 2015. We assessed the method of adaptation, and the quality of included guidelines. RESULTS: Seventy–two papers were eligible. Most adapted guidelines and their source guidelines were published by professional societies (71% and 68% respectively), and in high–income countries (83% and 85% respectively). Of the 57 adapted guidelines that reported any detail about adaptation method, 34 (60%) did not use a published adaptation method. The number (and percentage) of adapted guidelines fulfilling each of the ADAPTE steps ranged between 2 (4%) and 57 (100%). The quality of adapted guidelines was highest for the “scope and purpose” domain and lowest for the “editorial independence” domain (respective mean percentages of the maximum possible scores were 93% and 43%). The mean score for “rigor of development” was 57%. CONCLUSION: Most adapted guidelines published in peer–reviewed journals do not report using a published adaptation method, and their adaptation quality was variable.