Seyed Behnam Jazayeri
1 
, Seyed Farzad Maroufi
1,2, Zahra Ghodsi
1,3, Heshmatollah Ghawami
4, Ahmad Pourrashidi
5, Abbas Amirjamshidi
5, Mojtaba Mojtahedzadeh
5,6, Jalil Arabkheradmand
7, Farzin Farahbakhsh
8,1, Maryam Shabany
2,1, Morteza Faghih-Jouibari
9, Michael G. Fehlings
10, Brian K. Kwon
11,12, James S. Harrop
13, Vafa Rahimi-Movaghar
1,3,9,14,15,16* 1 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3 Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
4 Neuropsychology Division, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
5 Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
6 Director of Fellowship Program in Clinical Pharmacy and Critical Care, Faculty of Pharmacy
7 Director, Defence Health Research C, Tehran, Iran
8 Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
9 Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
10 University of Toronto Spine Program and Toronto Western Hospital, Toronto, Ontario, Canada
11 International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
12 Department of Orthopaedics, Division of Spine, University of British Columbia, Vancouver, BC, Canada
13 Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA
14 Universal Scientific Education and Research Network (USERN), Tehran, Iran
15 Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
16 Visiting Professor, Spine Program, University of Toronto, Toronto, Canada
*Corresponding Author: Corresponding Author: Vafa Rahimi-Movaghar, MD, Professor of Neurosurgery, Director of Traumatic Spinal Cord Injury, NSCIR-IR Principal Investigator, Sina Trauma and Surgery Research Center, Sina Hospital, Hassan Abad Square, Imam Khomeini Avenue, Tehran, Iran. Visiting Professor, Spine Program, University of Toronto. Tel:+1(226)919-8541, E-mail: v_rahimi@sina.tums.ac.ir, , Email:
v_rahimi@yahoo.com
Abstract
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 SCI patients.