scholarly journals Lipman A, Jackson K, Tyler L, editors. Evidence based symptom control in palliative care: systematic reviews and validated clinical practice guidelines for 15 common problems in patients with life limiting disease. New York: Pharmaceutical Products Press, 2000.

2003 ◽  
Vol 8 (5) ◽  
pp. 136-136
Author(s):  
K. Stewart
Keyword(s):  
New York ◽  
Palliative Care ◽  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Symptom Control ◽  
Pharmaceutical Products ◽  
Evidence Based ◽  
Common Problems

scholarly journals A Description of the Trials, Reviews, and Practice Guidelines Indexed in the PEDro Database

2008 ◽  
Vol 88 (9) ◽  
pp. 1068-1077 ◽  
Author(s):  
Christopher G Maher ◽  
Anne M Moseley ◽  
Cathie Sherrington ◽  
Mark R Elkins ◽  
Robert D Herbert
Keyword(s):  
Clinical Practice ◽  
Physical Therapy ◽  
Randomized Controlled Trials ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
History Of

This perspective provides an overview of the randomized controlled trials, systematic reviews, and evidence-based clinical practice guidelines in physical therapy. Data from the Physiotherapy Evidence Database (PEDro) are used to describe key events in the history of physical therapy research and the growth of evidence of effects of interventions used in the various subdisciplines of physical therapy. The 11,494 records that were identified reveal a rich history of physical therapy research dating back to the first trial in 1929. Most of the randomized controlled trials, systematic reviews, and evidence-based clinical practice guidelines in physical therapy have been published since the year 2000. This rapid growth presents a challenge for physical therapists who want to keep up to date in clinical practice.

scholarly journals Informasjonskilder for kunnskapsbasert praksis

2013 ◽  
Vol 23 (2) ◽  
Author(s):  
Sari Susanna Ormstad ◽  
Hege Underdal
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Procedures ◽  
Electronic Health ◽  
Mcmaster University

<p>Fremveksten av kunnskapsbasert praksis har ført til økt fokus på å gjøre forskningsbasert kunnskap lettere tilgjengelig. 6S-pyramiden, som er utviklet av McMaster University i Canada, er en modell som viser hvordan helsefaglig forskning kan plasseres på seks ulike nivåer, avhengig av graden av oppsummering og kvalitetsvurdering. Modellen kan brukes som et verktøy når man skal velge relevante søkekilder.</p><p>Den mest sammenstilte kunnskapen om ulike tilstander og sykdommer finner man i kliniske oppslagsverk og kunnskapsbaserte retningslinjer. De har som formål å tilby kunnskapsbaserte og oppdaterte anbefalinger om diagnostisering, behandling og oppfølging av spesifikke utvalgte tilstander i lettlest format.</p><p>Om man søker etter litteratur til bruk i utarbeidelsen av fagprosedyrer, retningslinjer, systematiske oversikter eller lignende oppsummeringer, må det utføres søk i bibliografiske databaser og andre lignende kilder. Man bør først lete etter systematiske oversikter og eventuelt utvide søket etter primærstudier dersom man ikke finner oppdaterte, relevante systematiske oversikter.</p><p>Helsebiblioteket.no er et offentlig finansiert nettbibliotek som gir gratis tilgang til norske og internasjonale kunnskapskilder. Helsebiblioteket kjøper tilgang til lisensbelagte ressurser som kliniske oppslagsverk, databaser og tidsskrifter. Mange av kildene nevnt i denne artikkelen inngår i Helsebibliotekets samling. I tillegg er nettsiden en delingsplattform for norske retningslinjer, prosedyrer og annet stoff som utvikles i det offentlige helse-Norge.</p><p>Ormstad SS, Underdal H. <strong>Information sources for evidence-based practice</strong>. <em>Nor J Epidemiol</em> 2013; <strong>23</strong> (2): 221-224.</p><p><strong>ENGLISH SUMMARY </strong></p><p>The development of evidence-based practice has led to an increased focus on making research-based evidence easily accessible. The 6S model, developed by McMaster University in Canada, is a model that describes how health-related research evidence can be sorted out on six different levels. The higher one comes in the model, the more summarized and quality-assured the evidence is. The 6S model can be used as a tool when selecting relevant sources for the literature search.</p><p>The most compiled evidence on various conditions and diseases can be found in evidence-based point of care tools and clinical practice guidelines. They are designed to offer comprehensive and up-to-date recommendations on diagnosis, treatment and monitoring of specific conditions condensed into easily digestible formats.</p><p>When looking for relevant research evidence to be included in clinical procedures, clinical practice guidelines, systematic reviews and other evidence syntheses, one should conduct searches in bibliographic databases and other similar sources. One should first try to find systematic reviews or similar evidence syntheses written about the topic of interest, and expand the search for primary studies only if no relevant up-to-date systematic reviews are available.</p><p>The Norwegian Electronic Health Library (helsebiblioteket.no) is a publicly funded e-library that provides free access to many Norwegian and international sources. The Norwegian Electronic Health Library purchases access to licensed resources, such as clinical reference works, databases, and journals. Many of the sources mentioned in this article are included in the collection of the Electronic Health Library. In addition, the e-library is a sharing platform for Norwegian clinical practice guidelines, clinical procedures, and other materials developed in the public health care system in Norway.</p>

scholarly journals An Introduction to an Evidence-Based Approach to Interventional Techniques in the Management of Chronic Spinal Pain

2009 ◽  
Vol 4;12 (4;7) ◽  
pp. E1-E33
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Evidence Based Medicine ◽  
Evidence Synthesis ◽  
Evidence Based ◽  
Clinical Question ◽  
Based Medicine

Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Clinical practice guidelines present statements of best practice based on a thorough evaluation of the evidence from published studies on the outcomes of treatment. In November 1989, Congress mandated the creation of the Agency for Healthcare Policy and Research (AHCPR). AHCPR was given broad responsibility for supporting research, data development, and related activities. Associated with this mandate, the National Academy of Sciences published a document indicating that guidelines are expected to enhance the quality, appropriateness, and effectiveness of health care services. Guidelines as a whole have been characterized by multiple conflicts in terminology and technique. These conflicts are notable for the confusion they create and for what they reflect about differences in values, experiences, and interest among different parties. Despite this confusion, public and private development of guidelines is growing exponentially. There are only limited means to coordinate these guidelines in order to resolve inconsistencies, fill in gaps, track applications and results, and assess the soundness of individual guidelines. Significant diversity exists in clinical practice guidelines. The inconsistency amongst guidelines arises from variations in values, tolerance for risks, preferences, expertise, and conflicts of interest. In 2000, the American Society of Interventional Pain Physicians (ASIPP) first created treatment guidelines to help practitioners. There have been 4 subsequent updates. These guidelines address the issues of systematic evaluation and ongoing care of chronic or persistent pain, and provide information about the scientific basis of recommended procedures. These guidelines are expected to increase patient compliance, dispel misconceptions among providers and patients, manage patient expectations reasonably, and form the basis of a therapeutic partnership between the patient, the provider, and payors. The ASIPP guidelines are based on evidence-based medicine (EBM). EBM is in turn based on 4 basic contingencies: the recognition of the patient’s problem and the construction of a structured clinical question; the ability to efficiently and effectively search the medical literature to retrieve the best available evidence to answer the clinical question; clinical appraisal of the evidence; and integration of the evidence with all aspects of the individual patient’s decision-making to determine the best clinical care of the patient. Evidence synthesis for guidelines includes the review of all relevant systematic reviews and individual articles, grading them for relevance, methodologic quality, consistency, and recommendations. Key words: Evidence-based medicine, clinical practice guidelines, critical appraisal, guideline development, interventional pain management, interventional techniques, evidence synthesis, clinical relevance, grading recommendations, systematic reviews

scholarly journals Methodology for Evidence Synthesis and Development of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain

2021 ◽  
Vol S1;24 (1;S1) ◽  
pp. S1-S26
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Observational Studies ◽  
Evidence Synthesis ◽  
Evidence Based ◽  
Interventional Techniques

BACKGROUND: The re-engineered definition of clinical guidelines in 2011 from the IOM (Institute of Medicine) states, “clinical practice guidelines are statements that include recommendations intended to optimize patient care that is informed by a systematic review of evidence and an assessment of the benefit and harms of alternative care options.” The revised definition distinguishes between the term “clinical practice guideline” and other forms of clinical guidance derived from widely disparate development processes, such as consensus statements, expert advice, and appropriate use criteria. OBJECTIVE: To assess the literature and develop methodology for evidence synthesis and development of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. METHODS: A systematic review of the literature including methodology of guideline development encompassing GRADE approach for guidance on evidence synthesis with recommendations. RESULTS: Some of the many factors described in 2011 continue as of 2020 and impede the development of clinical practice guidelines. These impediments include biases due to a variety of conflicts and confluence of interest, inappropriate and poor methodological quality, poor writing and ambiguous presentation, projecting a view that these are not applicable to individual patients or too restrictive with the elimination of clinician autonomy, and overzealous and inappropriate recommendations, either positive, negative, or non-committal. Thus, ideally, a knowledgeable, multidisciplinary panel of experts with true lack of bias and confluence of interest must develop guidelines based on a systematic review of the existing evidence. This manuscript describes evidence synthesis from observational studies, various types of randomized controlled trials (RCTs), and, finally, methodological and reporting quality of systematic reviews. The manuscript also describes various methods utilized in the assessment of the quality of observational studies, diagnostic accuracy studies, RCTs, and systematic reviews. LIMITATIONS: Paucity of publications with appropriate evidence synthesis methodology in reference to interventional techniques. CONCLUSION: This review described comprehensive evidence synthesis derived from systematic reviews, including methodologic quality and bias measurement. The manuscript described various methods utilized in the assessment of the quality of the systematic reviews, RCTs, diagnostic accuracy studies, and observational studies. KEY WORDS: Evidence-based medicine (EBM), interventional pain management, evidence synthesis, methodological quality assessment, conflict of interest, confluence of interest, comparative effectiveness research (CER), clinical practice guidelines, systematic reviews, meta-analysis

Clinical practice guidelines for comprehensive patient assessment in emergency care: A quality evaluation study

2021 ◽  
pp. 205715852110069
Author(s):  
Åsa Falchenberg ◽  
Ulf Andersson ◽  
Birgitta Wireklint Sundström ◽  
Anders Bremer ◽  
Henrik Andersson
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Emergency Care ◽  
Quality Evaluation ◽  
Evaluation Study ◽  
Evidence Based ◽  
Patient Assessment ◽  
Care Needs ◽  
Home Based

Emergency care nurses (ECNs) face several challenges when they assess patients with different symptoms, signs, and conditions to determine patients’ care needs. Patients’ care needs do not always originate from physical or biomedical dysfunctions. To provide effective patient-centred care, ECNs must be sensitive to patients’ unique medical, physical, psychological, social, and existential needs. Clinical practice guidelines (CPGs) provide guidance for ECNs in such assessments. The aim of this study was to evaluate the quality of CPGs for comprehensive patient assessments in emergency care. A quality evaluation study was conducted in Sweden in 2017. Managers from 97 organizations (25 emergency medical services and 72 emergency departments) were contacted, covering all 20 Swedish county councils. Fifteen guidelines were appraised using the validated Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. The results revealed that various CPGs are used in emergency care, but none of the CPGs support ECNs in performing a comprehensive patient assessment; rather, the CPGs address parts of the assessment primarily related to biomedical needs. The results also demonstrate that the foundation for evidence-based CPGs is weak and cannot confirm that an ECN has the prerequisites to assess patients and refer them to treatment, such as home-based self-care. This may indicate that Swedish emergency care services utilize non-evidence-based guidelines. This implies that ECN managers and educators should actively seek more effective ways of highlighting and safeguarding patients’ various care needs using more comprehensive guidelines.

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