Contextual differences considered in the Tunisian ADOLOPMENT of the European guidelines on breast cancer screening

Abstract Background Breast cancer is a common disease in Tunisia and associated with high mortality rates. The “Instance Nationale de l’Evaluation et l’Accréditation en Santé” (INEAS) the Tunisian Society of Oncology decided to develop practice guidelines on subject. While development novo breast screening demanding process, guideline adaptation appears more appropriate context sensitive. objective this paper describe process European Guidelines Cancer Screening Diagnosis setting terms methodological contextual differences between source adoloped guideline, changes recommendations. Methods We used ‘Grading Recommendations Assessment, Development Evaluation’ (GRADE)-ADOLOPMENT methodology prioritize topic, select questions outcomes. Once was selected—the Guidelines—the Commission´s Joint Research Centre shared project team all relevant documents files. In parallel, searched for local studies prevalence, outcomes’ baseline risks, patients’ values preferences, cost, cost-effectiveness, acceptability, feasibility. Then, adoloping panel reviewed GRADE evidence tables Evidence Decision discussed whether their own judgments were consistent those from or not. They based health effects, evidence, experiences. Results most related perspective, scope, prioritized questions, rating outcome importance, indirectness evidence. ADOLOPMENT resulted keeping 5 out 6 recommendations unmodified. One recommendation addressing “screening versus no ultrasound women density mammography screening” modified ‘conditional against’ either’ due favorable ratings by equity Conclusion This illustrates both feasibility GRADE-ADOLOPMENT approach importance consideration It also highlights value collaboration organization that developed guideline.