The aim of this study was to develop an educational video introducing an innovative panel survey approach to facilitate guideline panels in making inferences about patient values and preferences.

A user testing of the educational video through one-on-one interviews and iterative refinement of the video through brainstorming meetings.

Interviews and brainstorming meetings were conducted through Zoom.

The participants of the interviews include guideline panellists who had used the panel survey approach, and guideline panellists who had not used the approach but would or would not participate in a panel survey soon. The participants of the brainstorming meetings were a steering committee with expertise in guideline methodology and qualitative research.

The understandability and usefulness of the educational video.

We interviewed 18 guideline panellists from eight different guideline panels, all of whom carefully reviewed the video. Most participants found the video useful in explaining the panel survey approach and its role in incorporating patient values and preferences. Participants suggested improvements, including clarifying key concepts and using plain language instead of technical terminology to make the content more accessible. The major change the steering committee decided to make through brainstorming meetings was to add clarification, refine the wording and replace some text with animation.

User testing resulted in an improved educational video that is more useful and understandable for guideline panellists. Wider implementation of this resource has the potential to enhance the incorporation of patient values and preferences in guideline recommendations, supporting more patient-centred decision-making.

We aimed to assess usage and explore factors influencing the suitability of British Medical Journal (BMJ) Rapid Recommendations—a set of international guidelines meeting standards of trustworthiness—for adaptation and implementation, further defined as implementability.

Qualitative descriptive study with a multimethod approach.

We used citation screening and a survey to identify groups that had used any of a sample of 14 BMJ Rapid Recommendations in adoption, adaptation, de novo guideline development or implementation.

12 participants from a range of country income levels were interviewed, using semistructured interviews.

Interviews were analysed using thematic analysis to identify themes related to implementability of the guidelines. We compared these findings with those from a critical appraisal conducted using three different appraisal tools.

BMJ Rapid Recommendations are used in high-income, middle-income and low-income countries. We identified 33 instances of use. Our thematic analysis of the interviews uncovered 14 challenges to implementability, categorised under perceived trustworthiness, comprehensibility and practical relevance. The critical appraisals gave the BMJ Rapid Recommendations high scores on validity, but low scores on implementability and measurability. The challenges found in the interviews were generally corroborated by the appraisals, but the comparison also exposed tensions such as the complex interaction between methodological rigour and perceived credibility, the balance between novelty and compatibility with current practice, and the difficulty of offering globally applicable yet locally practical guidance.

Implementability challenges may limit effective use of international guidelines globally. Recognising and reflecting on tensions between rigour, credibility and contextual feasibility may help improve their uptake and value. The next phase of this research will explore strategies to enhance guideline implementability during their development.