[Not Available]. / ¿Podemos simplificar la elaboración de guías de práctica clínica? Evaluación de un método de elaboración, adaptación y actualización en la guía de práctica clínica sobre asma en la Comunidad Autónoma del País Vasco.

OBJECTIVE: Preparing clinical practice guidelines (CPG) is an expensive process requiring a great deal of time and the participation of numerous professionals with knowledge of methodology. But the use of higher-quality CPGs could make this process easier. The aim of this work was to evaluate the application of a composite development-adaptation-updating method for the development of the asthma CPG in the Basque Country Autonomous Community. METHOD: A four step process was followed: a) Drawing up of clinical questions and searching for CPGs and Cochrane reviews; b) Guidelines evaluation using the AGREE tool; c) Analysis of the clinical content using the "Table of Guidelines", and d) Application of 7 criteria to evaluate whether guidelines and Cochrane reviews adequately resolved each question. Obtained results determined the applied strategy: de novo development, partial development (abbreviated search and evaluation) or adoption of guidelines and/or Cochrane reviews recommendations. RESULTS: Twenty nine questions were formulated and 7 CPGs were selected. Out of the total questions, 86.2% were covered by guidelines while 37.9% by Cochrane reviews. Consistency rate was high, up to 53.6%. Updating was required in 75%. Of the recommendations, 46.4% were strongly graded and 39.3% by consensus. The strategy followed was of partial development in 62.1%, "de novo" in 13.8% and adoption of guidelines/Cochrane reviews in 24.1%. Statistically significant differences were observed in the previous criteria according to the type of question (diagnosis, treatment, education, prevention). CONCLUSIONS: Despite the availability of high-quality guidelines, many questions required partial development. However, this study provides a number of key aspects for future guideline development/ adaptationprojects.

¿Podemos simplificar la elaboración de guías de práctica clínica? Evaluación de un método de elaboración, adaptación y actualización en la guía de práctica clínica sobre asma en la Comunidad Autónoma del País Vasco / It is possible to simplify the development of clinical practice guidelines? Evaluation of method for updating, adapting and developing asthma guidelines in the Basque Country Autonomous Community

Objetivo: La elaboración de guías de práctica clínica (GPC) es un proceso costoso, que requiere mucho tiempo y profesionales con conocimientos metodológicos. La utilización de otras GPC de calidad podría facilitar el proceso. El objetivo es evaluar la aplicaciónde un método mixto de elaboración-adaptación-actualización en el desarrollo de la GPC sobre asma de la Comunidad Autónoma del País Vasco.Método: Se han seguido varias etapas: a) formulación de preguntas, búsqueda de GPC y revisiones Cochrane; b) evaluación de guías con el instrumento AGREE; c) análisis del contenido clínico mediante la“Tabla de guías”, y d) aplicación de siete criterios para evaluar si las guías y las revisiones Cochrane responden adecuadamente a cada pregunta. Según su cumplimiento, se seleccionó la estrategiaa seguir: elaboración de novo, elaboración parcial (búsqueda y evaluación abreviadas) o adopción de las recomendaciones a partir de guías y/o revisiones Cochrane.Resultados: Se formularon 29 preguntas clínicas y se seleccionaron 7 GPC. El 86,2% de las preguntas estaban abordadas en GPC y el 37,9%, con revisiones Cochrane. La consistencia fue alta en un 53,6%. Hubo necesidad de actualización en el 75%. La graduación de las recomendaciones fue fuerte en el 46,4%, y por consenso enel 39,3%. La estrategia seguida fue de elaboración parcial en el 62,1%, “de novo” en el 13,8% y adopción de guías-Cochrane en el 24,1%. Se observaron diferencias estadísticamente significativas en los criterios anteriores según el tipo de pregunta (diagnóstico,tratamiento, educación, prevención).Conclusiones: A pesar de disponer de guías de calidad, muchas preguntas han precisado elaboración parcial. No obstante, este trabajo proporciona algunas claves para futuros trabajos de elaboración o adaptación de guías

Objective: Preparing clinical practice guidelines (CPG) is an expensive process requiring a great deal of time and the participation of numerous professionals with knowledge of methodology. But the use of higher-quality CPGs could make this process easier. The aimof this work was to evaluate the application of a composite development-adaptation-updating method for the development of the asthma CPG in the Basque Country Autonomous Community.Method: A four step process was followed: a) Drawing up of clinical questions and searching for CPGs and Cochrane reviews; b) Guidelines evaluation using the AGREE tool; c) Analysis of the clinicalcontent using the “Table of Guidelines”, and d) Application of 7 criteria to evaluate whether guidelines and Cochrane reviews adequatelyresolved each question. Obtained results determined theapplied strategy: de novo development, partial development (abbreviated search and evaluation) or adoption of guidelines and/or Cochrane reviews recommendations.Results: Twenty nine questions were formulated and 7 CPGs were selected. Out of the total questions, 86.2% were covered by guidelines while 37.9% by Cochrane reviews. Consistency rate was high,up to 53.6%. Updating was required in 75%. Of the recommendations, 46.4% were strongly graded and 39.3% by consensus. The strategy followed was of partial development in 62.1%, “de novo” in 13.8% and adoption of guidelines/Cochrane reviews in 24.1%.Statistically significant differences were observed in the previous criteria according to the type of question (diagnosis, treatment, education, prevention).Conclusions: Despite the availability of high-quality guidelines, many questions required partial development. However, this study provides a number of key aspects for future guideline development/adaptationprojects