DUMC Library: 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 there an appropriate specification of values associated with outcomes?
- 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:
<
li>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:
- Limit to practice guideline (publication type)
Ovid:
- Limit to practice guideline.pt. (publication type)
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 Sackett, D.L. Evidence-Based Medicine. How to Practice and Teach EBM. Churchill-Livingstone,
2nd edition, 2001 (pocket cards).
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Last modified on: 16-Dec-04