gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Adapting External Depression and ADHD Clinical Practice Guidelines (CPGs)

Meeting Abstract

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  • D. Price - Kaiser Permanente, Oakland, US
  • E. Stone - Kaiser Permanente, Oakland, US
  • C. Robbins - Kaiser Permanente, Oakland, US

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO73

doi: 10.3205/12gin105, urn:nbn:de:0183-12gin1056

Published: July 10, 2012

© 2012 Price et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: We developed our first CPG on Depression in 2002 and ADHD in 2007. These CPGs have been updated every two years since.

Context: Due to limited resources, we sought to evaluate and adopt/adapt external Depression and ADHD CPGs instead of updating our previous guidelines in these topic areas. Using the ADAPTE process, we conducted a systematic review for all relevant external guidelines and found five Depression and three ADHD guidelines. We screened these guidelines using the Rigor Domain of the AGREE II tool. Only those external guidelines that had a high rigor score were further evaluated using the entire AGREE II tool. Guidelines that scored a 60 or higher on the entire AGREE II tool were used as the basis for updating the Depression and ADHD guidelines.

Best Practice: We adapted the SIGN and NICE Guidelines for our ADHD Guideline. The Depression Guideline was based on external guidelines from SIGN, NICE, VA and USPSTF.

Lessons for guideline developers: The guideline development teams still invested significant time reconciling recommendations across several high quality guidelines with prior guidelines. This was especially due to differences in clinical practice and available resources between the United States and other countries (i.e., the United Kingdom). The first attempt to adapt an external guideline using the ADAPTE process and AGREE II tool was resource intensive. However, the potential for efficiency exists as we become more familiar with the ADAPTE process and AGREE II tool and begin to standardize our processes.