{
  "abstract": "Background The adaptation of clinical practice guidelines (CPGs) is increasingly used to efficiently develop contextualised recommendations for local, regional and national settings. However, adaptation approaches lack standardisation, and their application remains unclear.Objective To identify existing literature on CPG adaptation approaches, synthesise and analyse the definitions, rationales, key steps and their applications.Methods We conducted a scoping review and identified studies through (1) database searches in MEDLINE and EMBASE (October 2024); (2) forward citation searches (January 2024); (3) manual searches; and (4) expert recommendations. We included documents describing adaptation approaches that allow reproducibility or adapted guidelines reflecting their application, without language restriction. We analysed data using descriptive and content analysis, with visualisations using Tableau.Results We identified 49 adaptation approaches (2000–2024) and 151 applications (2007–2024). 28 approaches originated from high-income countries (57.1%), primarily aimed at improving guideline development efficiency. We categorised these approaches into methodological frameworks (n=16, 32.7%), medical association frameworks (n=7, 14.3%), organisational handbooks (n=12, 24.5%), national or regional approaches (n=13, 26.5%) and one topic-specific methodology. From the key adaptation steps of the identified approaches, we found that ‘judging quality of evidence’ and ‘establishing guideline group processes’ were the least addressed. Approximately 20% of applications modified the original approaches during the adaptation process. ADAPTE (n=50, 33.1%) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-ADOLOPMENT (n=41, 27.2%) are the most commonly used adaptation approaches. Also, over half of the identified applications were adapted at the evidence level (n=88, 58.3%) and completed the process within 12 months (range: 2–36 months).Conclusions 49 adaptation approaches were identified, with a recent surge in interest and utilisation. Although adaptation can save time and resources, substantial variations among existing approaches and their applications remain. These findings highlight the need for comprehensive guidance to support standardisation and optimise the quality of the adaptation process.",
  "authors": [
    {
      "affiliations": [
        "School of Medicine, The Chinese University of Hong Kong—Shenzhen, Shenzhen, China"
      ],
      "name": "Simin Zhu"
    },
    {
      "affiliations": [
        "Center for Clinical Practice Guideline Development and Evaluation, Children’s Hospital of Fudan University, Shanghai, China"
      ],
      "name": "Rui Wang"
    },
    {
      "affiliations": [
        "Departments of Anesthesia and Health Research Methods, McMaster University, Hamilton, Ontario, Canada",
        "Adaptation Working Group, Guidelines International Network, Perth, Scotland"
      ],
      "name": "Andrea J Darzi"
    },
    {
      "affiliations": [
        "Department of Health Research Methods,Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Yuan Zhang"
    },
    {
      "affiliations": [
        "Adaptation Working Group, Guidelines International Network, Perth, Scotland",
        "Department of Pediatrics and Corporate Quality Management, King Saud University Medical City, Riyadh, Riyadh, Saudi Arabia",
        "Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Riyadh Province, Saudi Arabia",
        "Clinical Practice Guidelines and Quality Research Unit, Corporate Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia",
        "Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil"
      ],
      "name": "Yasser Sami Amer"
    },
    {
      "affiliations": [
        "Departments of Anesthesia and Health Research Methods, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Kian Torabiardakani"
    },
    {
      "affiliations": [
        "Department of Health Research Methods,Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada",
        "Clinical Epidemiology and Research Center(CERC), IRCCS Humanitas ResearchHospital and Humanitas University, Pieve Emanuele, Milan, Italy"
      ],
      "name": "Holger J Schuenemann"
    },
    {
      "affiliations": [
        "Department of Health Research Methods,Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada",
        "Department of Internal Medicine, American University of Beirut, Beirut, Beirut Governorate, Lebanon"
      ],
      "name": "Elie Akl"
    },
    {
      "affiliations": [
        "Adaptation Working Group, Guidelines International Network, Perth, Scotland",
        "Biomedical Research Institute Sant Pau (IIB Sant Pau), Iberoamerican Cochrane Centre, Barcelona, Spain",
        "Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Community of Madrid, Spain"
      ],
      "name": "Pablo Alonso-Coello"
    },
    {
      "affiliations": [
        "School of Medicine, The Chinese University of Hong Kong—Shenzhen, Shenzhen, China",
        "Adaptation Working Group, Guidelines International Network, Perth, Scotland"
      ],
      "name": "Yang Song"
    }
  ],
  "title": "Current knowledge on the adaptation of clinical practice guidelines: a scoping review",
  "uid": "bb6563f9-f420-5846-b064-6014c4921b7e"
}