clinical guidelines 1.pptx

 Clinical guidelines as a resource for evidence-based physiotherapy Dr. Sidra Majeed;PT  Evidence-based clinical guidelines integrate high quality clinical research with contributions from clinical experts and patients, to formulate reliable recommendations for practice. Singl...

 Clinical guidelines as a resource for evidence-based physiotherapy Dr. Sidra Majeed;PT  Evidence-based clinical guidelines integrate high quality clinical research with contributions from clinical experts and patients, to formulate reliable recommendations for practice. Single source of information about the management of clinical conditions.  Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health for specific circumstances. A rigorous and systematic process is used to reach consensus about best practice. Recommendations for practice…recipes for health care Co-morbidity or a social situation Patient want different approach or specific treatment  Guideline is based on strong and relevant evidence….Recommendations should be implemented unless patient- related reason  Differences between systematic reviews and clinical guidelines Systematic review Clinical guideline 1. Small scope 1. Broad scope…may include many 2. Conclusions based on systematic reviews results from research 2. Conclusions based on alone research plus expert opinion, patient experience and consensus views 3. Limited role of patient 3. Key role of patients 4. Validity = 4. Validity = methodological methodological rigour rigour plus judgements made by guideline development group 5. Quick 5. Longer time required 6. Typically published 6. Published for health for health professionals plus professionals patients HISTORY OF CLINICAL GUIDELINES AND WHY THEY ARE IMPORTANT Links closely to the development of evidence-based medicine and evidence-based practice, Increasing volume of published literature…more manageable resource for busy practitioners. Consistency in the provision of health care Same (excellent) health care everywhere  Recommendations for practice need to be developed in a systematic, reliable and credible way…to be applied across a whole population. Insurance companies Patients knowledge of best treatment options Physical therapist…‘best practice’.  Many ‘guidelines’ are based on informal consensus, which in turn is based on a combination of opinion and shared experience. Before early 1990s…developed informally Recent years…systematic and evidence-based approach to developing guidelines  key processes The scientific evidence is assembled in a systematic fashion. The panel that develops the guideline includes representatives of most, if not all, relevant disciplines. The recommendations are explicitly linked to the evidence from which they are derived.  Non-systematic literature reviews may suffer from bias and provide ‘false reassurance’ Current practice, rather than promoting evidence-based practice From 2000 onwards, a more systematic approach to guideline development methodolgy  Focus on difficult problem of formulating recommendations where there is limited research evidence Impact of people on guideline development