Adapting World Health Organization COVID-19 living guidelines balancing methodological rigor with efficiency and flexibility: a case study from Argentina

Abstract

Objectives

We assessed the perceptions about a new methodological process to translate and adapt the World Health Organization living guidelines for COVID-19 recommendations for therapeutics in Argentina from the guideline development group's (GDG) perspective.

Methods

A tailored adaptation process, linked to a prototype tool and created as part of the GATEWAY project by the MAGIC Evidence Ecosystem Foundation, starts by assessing the recommendation and justification and then examining evidence to decision factors. We focused our evaluation on the adaptation process steps carried out from December 2022 to June 2023. We collected information through (1) observations of the panel meeting, (2) focus group with methods team, (3) semistructured interviews with panel members, (4) postpanel meeting survey, and (5) a satisfaction survey. We carried out descriptive analyses of surveys and content analysis of focus groups and interviews.

Results

GDG adapted four recommendations, of which two were modified in direction or strength and elaborated one de novo. The survey showed that most GDG members found the training session (89%) and prepanel meeting survey (100%) facilitated adaptation. Focus groups and interviews showed that GDG agreed that the process considered the relevant local factors to adapt the recommendations and that it was transparent and easy to understand, allowing it to reach a consensus efficiently. GDG valued the process's flexibility and time optimization. They considered the premeeting survey analysis crucial in facilitating the consensus.

Conclusion

From the GDG perspective, this case study demonstrated that this tailored approach provides a transparent, efficient, and rigorous methodology for translating and adapting the World Health Organization living guidelines for COVID-19.