MUSM Libraries: Evaluating a PRACTICE GUIDELINE article
Validity issues | Key characteristics | Finding articles
Validity issues
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?
Key characteristics
Clinical Practice Guidelines are systematically developed
statements designed to assist practitioners and patient decisions about
appropriate health care for specific clinical circumstances.
Key Characteristics:
- 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
PubMed:
PubMed for
Handhelds (Memorial On-Campus/Remote One and Mercer On-Campus access)
PubMed for
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.
References:
- 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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