Guideline Adaptation: An Appealing Alternative to De Novo Guideline Development
Bibliographic record
Abstract
Letters1 April 2008Guideline Adaptation: An Appealing Alternative to De Novo Guideline DevelopmentBeatrice Fervers, MD, MSc, Magali Remy-Stockinger, Msc, Ian D. Graham, PhD, Bernard Burnand, MD, MPH, Margaret Harrison, RN, PhD, George Browman, MD, MSc, and Jean Latreille, MDMBeatrice Fervers, MD, MScFrom Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Search for more papers by this author, Magali Remy-Stockinger, MscFrom Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Search for more papers by this author, Ian D. Graham, PhDFrom Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Search for more papers by this author, Bernard Burnand, MD, MPHFrom Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Search for more papers by this author, Margaret Harrison, RN, PhDFrom Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Search for more papers by this author, George Browman, MD, MScFrom Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Search for more papers by this author, and Jean Latreille, MDMFrom Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-7-200804010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The ADAPTE Collaboration (www.adapte.org) is an international group aiming to enhance the use of evidence through more efficient development and implementation of guidelines by guideline adaptation. We read with great interest about the process used by the American College of Physicians (ACP) to develop their statement for glycemic control (1). The development and maintenance of high-quality guidelines require substantial time, expertise, and resources, and the ACP has used an attractive alternative to de novo guideline development. Yet guideline adaptation also presents challenges. Although guideline developers often consider existing guidelines as a source of evidence, few are using ...References1. Qaseem A, Vijan S, Snow V, Cross T, Weiss KB, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Glycemic control and type 2 diabetes mellitus: the optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians. Ann Intern Med. 2007;147:417-22. [PMID: 17876024] LinkGoogle Scholar2. Graham ID, Harrison MB, Brouwers M, Davies BL, Dunn S. Facilitating the use of evidence in practice: evaluating and adapting clinical practice guidelines for local use by health care organizations. J Obstet Gynecol Neonatal Nurs. 2002;31:599-611. [PMID: 12353740] CrossrefMedlineGoogle Scholar3. Fervers B, Burgers JS, Haugh MC, Latreille J, Mlika-Cabanne N, Paquet L, et al. Adaptation of clinical guidelines: literature review and proposition for a framework and procedure. Int J Qual Health Care. 2006;18:167-76. [PMID: 16766601] CrossrefMedlineGoogle Scholar4. Shekelle P, Eccles MP, Grimshaw JM, Woolf SH. When should clinical guidelines be updated? BMJ. 2001;323:155-7. [PMID: 11463690] CrossrefMedlineGoogle Scholar5. Eisinger F, Geller G, Burke W, Holtzman NA. Cultural basis for differences between US and French clinical recommendations for women at increased risk of breast and ovarian cancer. Lancet. 1999;353:919-20. [PMID: 10094000] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Centre Léon Berard, Lyon F-69373, France; Canadian Institutes of Health Research, Ottawa, Ontario K1A 0W9, Canada; University of Lausanne, CH-1005 Lausanne, Switzerland; Queen's University, Ottawa, Ontario K7L 3N6, Canada; British Columbia Cancer Agency, Vancouver, British Columbia V6H 2E3, Canada; and Hôpital Charles LeMoyne, Longueuil, Québec J4V 2H1, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGlycemic Control and Type 2 Diabetes Mellitus: The Optimal Hemoglobin A1c Targets. A Guidance Statement from the American College of Physicians Amir Qaseem , Sandeep Vijan , Vincenza Snow , J. Thomas Cross , Kevin B. Weiss , Douglas K. Owens , and Guideline Adaptation: An Appealing Alternative to De Novo Guideline Development Valerie A. Palda , Ian D. Graham , Dave Davis , Jako Burgers , Melissa Brouwers , Françoise Cluzeau , and Guideline Adaptation: An Appealing Alternative to De Novo Guideline Development Amir Qaseem , Vincenza Snow , and Douglas Owens Metrics Cited ByGuidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised EditionDiagnosis and Treatment of Helicobacter Pylori Infection: Korean and Overseas GuidelinesHistorical Perspective of Helicobacter pylori Treatment in KoreaGuidelines for the diagnosis and treatment of Helicobacter pylori infection in Korea, 2013 revised editionGuidelines for the Diagnosis and Treatment of Helicobacter pylori Infection in Korea, 2013 Revised EditionKDOQI US Commentary on the 2009 KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of CKD–Mineral and Bone Disorder (CKD-MBD)The Systematic Guideline Review: Method, rationale, and test on chronic heart failure 1 April 2008Volume 148, Issue 7Page: 563-564KeywordsConflicts of interestResearch quality assessmentResearch reporting guidelines ePublished: 1 April 2008 Issue Published: 1 April 2008 CopyrightCopyright © 2008 by American College of Physicians. 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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.155 | 0.356 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.007 | 0.004 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.010 | 0.013 |
| Open science | 0.004 | 0.010 |
| Research integrity | 0.013 | 0.015 |
| Insufficient payload (model declined to judge) | 0.020 | 0.006 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".