Table 1

Steps in the adaptation process

PhasesModulesStepsTools
I. Set-up1.1 Preparation
  • Step 1. Establish an organising committee

  • Step 2. Select a guideline topic

  • Step 3. Check whether adaptation is feasible

  • Step 4. Identify necessary resources and skills

  • Step 5. Complete tasks for the Set-up phase

  • Step 6. Write adaptation plan

  • Tool 1: Guideline development and Implementation resources

  • Tool 2: Search sources and strategies

  • Tool 3: Sample declaration of conflict of interest

  • Tool 4: Consensus process resources

  • Tool 5: Workplan Example

II. Adaptation2.1 Scope and PurposeStep 7. Determine the health (clinical/policy questionsTool 6: PIPOH (Population, Intervention, Professional, Outcomes, Healthcare setting)
2.2 Search and Screen
  • Step 8. Search for guidelines and other relevant documents

  • Step 9. Screen retrieved guidelines

  • Step 10. Reduce a large number of retrieved guidelines

  • Tool 2: Search sources and strategies

  • Tool 7: Sample table for summarising guideline characteristics

  • Tool 8: Sample table for recording clinical content of guidelines

2.3 Assessment
  • Step 11. Assess guideline quality

  • Step 12. Assess guideline currency

  • Step 13. Assess guideline content

  • Step 14. Assess guideline consistency

  • Step 15. Assess acceptability/applicability of the recommendations

  • Tool 9: AGREE instrument

  • Tool 10: AGREE inter-rater agreement and score spreadsheets

  • Tool 11: Sample currency survey

  • Tool 12: Sample recommendations Matrix

  • Tool 13: Evaluation sheet—Search and selection of evidence

  • Tool 14: Evaluation sheet—Scientific validity of guidelines

  • Tool 15: Worksheet—Acceptability/applicability

2.4 Decision and Selection
  • Step 16. Review assessments

  • Step 17. Select among guidelines and recommendations to create an adapted guideline

Tool 16: List of all resources available to the panel
2.5 CustomisationStep 18. Prepare draft adapted guideline
  • Tool 17: Checklist of adapted guideline content

  • Tool 18: Report on results of updating process

III. Finalisation3.1 External Review and Acknowledgement
  • Step 19. External review by target users

  • Step 20. Consult with relevant endorsement bodies

  • Step 21. Consult with developers of source guidelines

  • Step 22. Acknowledge source documents

Tool 19: Samples of external review surveys
3.2 Aftercare planningStep 23. Plan scheduled review and update of adapted guideline
3.3 Final ProductionStep 24. Produce final guidance document