This question sounds interesting..and there can be different sets of answers altogether to this question..if viewed from different perspectives.

Now, I would like to explain my perspective here..

I believe that -as a medical doctor or scientist or as a researcher, all the people of this community should have one and only ultimate goal -"Serve Humanity and Save Lives".

Thus, no matter what we, being the people of this profession, should always give our very best in saving the lives of people who are suffering from any serious illness or disease.

Thus, sometimes it might happen that patients have come up with a newly emerged or a very rare disease in a country, to which there maybe no proper guidelines made by the nation..

but that doesn't or rather should not stop us from providing treatment to a patient who might die maybe if not given treatment on time.

Hence, at that time, without wasting time any further, we should look for the guidelines of the same or similar diseases made by foreign research associations or societies.

Moreover,as I said earlier...that the doctors, scientists or researchers all over the world have been serving this world and humanity for ages..so they are having similar ideas,concepts, insights and approaches to diseases and its outcomes, diagnosis, management and prognosis...yes, they might differ in opinions sometimes..but their primary goal is always the same- to treat and save lives of people..so they can never be bound by narrow borders of nationality or religion,gender,creed or race.

I would also like to add evidences of my claim here-

I guess you have seen already that during Covid pandemic last year, there was no proper guidelines made initially and the approach to treat it varied significantly accross different countries...in some countries, remdesivir was supported as a drug for treatment of covid affected patients..while in some countries,it wasn't allowed... similarly with hydroxychloroquine,there were different sets of opinions..

so no nation waited for taking time and framing guidelines and then treating patients ( because that could endanger lives of many and Covid 19 was a newly emerged disease)...rather they started observing and following what drugs were being used in other countries..like USA ,UK,Italy etc..and any other intervention that was applied..like plasma therapy etc..

also it was found that there was some benefits of using Corticosteroids..as it saved lives of many such patients..

hence,it started to be followed and used in other countries as well..

*Also it is advisable to remember that most of the guidelines that we follow to treat the diseases of people are made by foreign associations or societies only...and they are followed all over the world..

eg..ACR criteria for Rheumatoid arthritis, WHO guidelines on several diseases,NYHA guidelines for cardiovascular diseases etc.

I hope I could make it clear to some extent..that saving lives of people should be our primary goal..hence, there is no harm to refer to and follow foreign guidelines on treatment of similar diseases..if that disease entity affects people of one's nation...

I know there maybe conflicts and discrepancies at times or difference in opinions across countries regarding usage of a particular drug entity for a specific disease ...but if this becomes essential to save the life of a person, no other options remain other than this!

Thank you once again for asking this question!

Thank you Suvam Banerjee for your input and you have correctly mentioned that, without guidelines, we have been treating local patients probably since the birth of this Indian subcontinent and today life span of Bangladeshi is on average 72 years. The problem is that the evidence-based practice has not been exercised homogeneously which delays or complicates treatment outcomes and create more financial burden on the community.

Another problem is that the country-specific guidelines are prepared on the basis of local RCTs and other studies of that particular population and when you try to compile or merge the study findings of different countries, there is probably no specific statistical approach for that which is possible nicely by meta-analysis or systematic review of specific interventions. And it is a really hectic job to complete SR chronologically and make a foundation for preparing a guideline or treatment or management directive.

The bottom line is that it is better to exercise evidence-based practice and at the same time, there should be harmony among the different levels of the health care system to follow those evidence.

(Note: Of course we should keep in mind about value-based practice also)

Yes it can be made according to available local resources

If there is inadequate local evidence, then what will be rationale of preparing a local guidelines rather following international ones as it is with clinical tailoring

As a member of the depression guideline subgroup, I have summarised 10 guidelines and I found that different guidelines have a different approaches and there are similarities along with contrast issues. It is really easy to compile them put them in one frame. But, yet I am really confused, whether it's a scientifically sound approach to merge RCTs of different countries in a common space?