MUSM Libraries: Evaluating a PRACTICE GUIDELINE article
Validity issues | Key characteristics | Finding articles
Are the recommendations valid?
- Did the recommendations consider all relevant patient groups,
management options, and possible outcomes?
- Is there a systematic review of evidence linking options to outcomes
for each relevant question?
- Is each of its recommendations both tagged by the level of evidence
upon which it is based and linked to a specific citation?
- Do the authors indicate the strength of their recommendations?
What are the results?
- What are the key recommendations?
Will the results help you in caring for your patient?
- Do the recommendations make sense in your practice setting?
Clinical Practice Guidelines are systematically developed
statements designed to assist practitioners and patient decisions about
appropriate health care for specific clinical circumstances.
- comprehensive review of evidence
- expert opinion used ot make value judgements
- official endorsement(s)
- intention to influence your practice patterns
Values are the basis for personal preferences concerning
different clinical outcomes.
Grades of Recommendations:
(JAMA 1995 274:1800-1804)
- A1: RCTs, no heterogeneity, CIs clear threshold NNT
- A2: RCTs, no heterogeneity, CIs cross threshold NNT
- B1: RCTs, heterogeneity, CIs clear threshold NNT
- B2: RCTs, no heterogeneity, CIs cross threshold NNT
- C1: Observational studies, CIs clear threshold NNT
- C2: Observational studies, CIs cross threshold NNT
Finding articles about practice guidelines
Handhelds (Memorial On-Campus/Remote One and Mercer On-Campus access)
Handhelds (Mercer Off-Campus access)
- SelectSearch MEDLINE/PubMed and use the Search with no
filters and enter your search term/s AND practice guideline[pt]
- Alternatively, select PICO search and choose Practice
Guideline from the Publication type drop down menu.
- JAMA 1995 274:570-574
- JAMA 1995 274:1630-1632
From: Guyatt, G. Users' Guides to the Medical Literature: Essentials of
Evidence-based Clinical Practice. AMA Press, 2002 and Straus. Evidence-Based
Medicine. How to Practice and Teach EBM. Churchill-Livingstone, 3rd
edition, 2005 (pocket cards).
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