Latin American panelists find GRADE-ADOLOPMENT useful and important to contextualize recommendations in their region

Zil H. Nasir, Tamara Lotfi, Juan J. Yepes Nuñez, Yuan Zhang, Ignacio Neumann, Holger J. Schünemann*

*Autor correspondiente de este trabajo

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

1 Cita (Scopus)

Resumen

BACKGROUND GRADE-ADOLOPMENT is widely applied to efficiently use existing credible guidelines and contextualize them to a target setting. OBJECTIVES To highlight the experiences of a Latin American Guideline Development Group applying GRADE-ADOLOPMENT to adapt the American Society of Hematology's clinical practice guideline on managing venous thromboembolisms in Latin America. STUDY DESIGN AND SETTING We employed a mixed-methods post-evaluation using self-administered surveys and semi-structured interviews. We assessed the Latin American guideline development group's (GDG) (1) general satisfaction and confidence using the approach (2) their ratings on the usefulness, appropriateness, and importance of GRADE-ADOLOPMENT and its tools to inform their judgements and (3) any additional facilitators and barriers to refine the process. RESULTS Eleven of the 14 GDG members including nine panelists and two methodologists, provided survey responses and eight participated in the interview. Respondents felt "mostly" or "completely" satisfied with the adapted guideline. Eight panelists surveyed agree GRADE-ADOLOPMENT is useful in countries with limited resources. Although panelists expressed initial apprehensions in their understanding of the process, they demonstrated enhanced confidence in their capacity to apply GRADE after completing workshop training and by acquiring experience. Panelists re-iterated the importance of considering evidence-to-decision criteria (i.e., resources, feasibility, and cost-effectiveness) when adapting recommendations. The GDG encountered challenges with collecting local and regional data, prioritizing recommendations while considering intra-regional diversity, and the lengthy publication period, although the latter stemmed from procedures not related to GRADE-ADOLOPMENT. CONCLUSIONS GRADE-ADOLOPMENT is an important tool to facilitate the adaptation and uptake of clinical practice guidelines in novel settings. The GDG felt satisfied with their overall experience using the GRADE-ADOLOPMENT approach. However, their experience could have been optimized if they had access to robust regional evidence, more recommendations to adapt from, and worked with more efficient guideline production timelines.
Idioma originalInglés
Número de artículo111483
Páginas (desde-hasta)111483
PublicaciónJournal of Clinical Epidemiology
Volumen175
DOI
EstadoPublicada - 2024

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