# Adapting the ADAPTE framework for Traditional Chinese Medicine clinical practice guidelines: a methodological study

## TL;DR

Researchers adapted the ADAPTE framework to better suit Traditional Chinese Medicine guidelines, addressing unique challenges in standardizing TCM care.

## Contribution

A modified ADAPTE framework tailored for Traditional Chinese Medicine clinical guidelines was developed and validated.

## Key findings

- A dual-tiered working group identified key challenges in applying the original ADAPTE process to TCM guidelines.
- 21 experts reached high consensus on the modified ADAPTE-TCM framework after suggested modifications.
- The final ADAPTE-TCM framework includes 20 modified steps and TCM-specific evaluation criteria.

## Abstract

Clinical practice guideline adaptation is critical for standardizing care, yet existing frameworks like the ADAPTE process lack specificity for Traditional Chinese Medicine (TCM), whose principles diverge fundamentally from western medicine. To address this gap, we modified the ADAPTE process to align with the unique characteristics of TCM. A dual-tiered working group (core team and expert panel) simulated tested the original ADAPTE process on Traditional Chinese Medicine clinical practice guidelines (TCM CPGs), identifying challenges such as incompatibility with TCM diagnostic frameworks and holistic treatment paradigms and formed the initial version of ADAPTE-TCM. 21 experts were invited to evaluate the initial version of ADAPTE-TCM and reached a high consensus, while also providing suggestions for modifications to the initial version. Ultimately, 20 steps were modified (e.g., evidence synthesis, consensus-building) and integration of TCM CPGs specific evaluation criteria and tool. The resulting ADAPTE-TCM framework provides methodological rigor for adapting TCM CPGs. This adaptation not only bridges a critical gap in TCM CPGs adaptation but also exemplifies how evidence-based methodologies can evolve to respect diverse medical traditions.

The online version contains supplementary material available at 10.1186/s13020-026-01323-1.