Improving the use of research evidence in guideline development: 13. Applicability, transferability and adaptation

Schünemann, Holger J; Fretheim, Atle; Oxman, Andrew D

The methods used to prepare this review are described in the introduction to this series [29] . Briefly, the key questions addressed in this paper were vetted amongst the authors and the ACHR Subcommittee on the Use of Research Evidence (SURE). For this review we analyzed existing guidelines for guidelines of national or interna-tional organizations to identify processes that these organizations use to adapt guidelines locally beyond what was known for existing organizations as described in the background section. We also searched PubMed using "guideline" AND "adaptation OR applicability OR template OR transferability" (MESH headings/keywords) for studies and systematic reviews comparing different strategies to increase adaptation, acceptance and transferability (we identified 637 citations of which 203 citations were identified as systematic reviews using the clinical queries filter for systematic reviews). We reviewed the titles of all citations and retrieved abstracts and full text articles if the citations appeared relevant to the topic. We checked the reference lists of articles relevant to the questions and used snowballing as a technique to obtain additional information. We also searched the Cochrane Library and Google for articles and methods related to guideline adaptation ("guideline adaptation"). In addition, we searched databases maintained by the Agency for Healthcare Research and Quality (AHRQ, [30] ) and the Guidelines International Network (GIN, [31] ). The answers to the questions are our conclusions based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments.