PHTY211 Lecture Notes - Lecture 10: Confidence Interval, Rigour, Editorial Independence
Appraising clinical guidelines and implementing EBP
• Explain the difference between a systematic review and a clinical guideline
o Clinical guidelines
▪ Systematically developed statements on disease management
▪ The statements are developed by a body of stakeholders and are often based
on best available research evidence, expert opinion and patient experiences
▪ Clinical guidelines act as a comprehensive resource of high quality information
▪ Assist practitioner and patient decisions about appropriate healthcare for
specific circumstances
▪ Acknowl3edge patients right to make decision
▪ PT are responsible to provide information decision making
o History of clinical guideline development
▪ Linked with development of EBP
▪ Increased literature difficult to keep up with
• Provide summaries of high quality research
▪ Government calls for consistency of care
▪ Patient request for information about treatment options
o Appraising a clinical guideline
▪ Who developed the guideline?
• They describe who has been involved
• Show the process to identify key stakeholders
• Importance of having representatives from different backgrounds
involved in the development of the guideline
o Diversity of views of patients, practitioners, researchers etc. And
to reduce bias
▪ How were the recommendations developed?
• Based on up to date and high quality systematic reviews
• Explicitly report
o Quality/levels of evidence
▪ Different clinical questions need different research designs
▪ Applicable to evidence about intervention
▪ Summarise evidence – as for systematic reviews
o Strength of recommendations
▪ Recommendations for practice
• Considerations of benefit and harm
• Judgement about what evidence means for patients
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Document Summary
Appraising clinical guidelines and implementing ebp: explain the difference between a systematic review and a clinical guideline, clinical guidelines. Importance of having representatives from different backgrounds involved in the development of the guideline: diversity of views of patients, practitioners, researchers etc. And to reduce bias: how were the recommendations developed, based on up to date and high quality systematic reviews, explicitly report, quality/levels of evidence, different clinical questions need different research designs, applicable to evidence about intervention. Summarise evidence as for systematic reviews: strength of recommendations, recommendations for practice, considerations of benefit and harm. Judgement about what evidence means for patients: example of quality of evidence. Scope and purpose: concerned with the overall aim of the guideline, the specific health questions, and the target population (items 1-3) Stakeholder involvement: the representation of different stakeholders and how diverse it is, rigour of development. Strong recommendation for using rx: do it.
