Adopting Clinical Practice Guidelines for Pharmacologic Management of Acute Spinal Cord Injury from a Developed World Context to a Developing Global Region.
Seyed Behnam Jazayeri, Seyed Farzad Maroufi, Zahra Ghodsi, Heshmatollah Ghawami, Ahmad Pourrashidi, Abbas Amirjamshidi, Mojtaba Mojtahedzadeh, Jalil Arabkheradmand, Farzin Farahbakhsh, Maryam Shabany, Morteza Faghih-Jouibari, Michael G Fehlings, Brian K Kwon, James S Harrop, Vafa Rahimi-Movaghar
Author Information
Seyed Behnam Jazayeri: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. ORCID
Seyed Farzad Maroufi: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Zahra Ghodsi: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Heshmatollah Ghawami: Neuropsychology Division, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Ahmad Pourrashidi: Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Abbas Amirjamshidi: Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mojtaba Mojtahedzadeh: Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Jalil Arabkheradmand: Director, Defence Health Research C, Tehran, Iran.
Farzin Farahbakhsh: Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Maryam Shabany: Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Morteza Faghih-Jouibari: Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Michael G Fehlings: University of Toronto Spine Program and Toronto Western Hospital, Toronto, Ontario, Canada.
Brian K Kwon: International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
James S Harrop: Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Vafa Rahimi-Movaghar: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. ORCID
BACKGROUND: Proper utilization of high-quality clinical practice guidelines (CPGs) eliminates the dependence of patients' outcomes on the ability and knowledge of "individual" health care providers and reduces unwarranted variation in care. The aim of this study was to adapt/adopt two CPGs for pharmacologic management of acute Spinal Cord Injury (SCI) using guideline adaptation methods. METHODS: This study was conducted based on the ADAPTE process. Following establishment of an organizing committee and choosing the health topics, we appraised the quality of the CPGs using the Appraisal of Clinical Guidelines for Research & Evaluation II (AGREE II). Then, the authors extracted and categorized suggestions according to Population, Intervention, Professions, Outcomes and Health care setting (PIPOH). The decision-making process was based on systemic evaluation of each suggestion, utilizing a combination of AGREE II scores, the quality of supporting evidence for or against each suggestion and the triad of feasibility, acceptance and adoptability for the Iranian health-care context. RESULTS: Two guidelines were included in the adaptation process. Based on high-quality of these guidelines and the feasibility and adoptability evaluation of the organizing committee, we decided to adopt the suggestion of both guidelines. Overall, seven suggestions were extracted from the source guidelines. CONCLUSION: This work provides a framework to apply guidelines for acute SCI to the developing regions of the world. Attempts should be made to implement these suggestions in order to improve the health outcomes of Iranian SCIpatients.
