8 - Clinical Practice Guidelines**

Question 1

Define clinical practice guidelines

Answer 1

Systematically developed statements to assist practitioner and pt decisions about appropriate health care for specific clinical circumstances

Question 2

Purpose of clinical practice guidelines

Answer 2

To make explicit recommendations w/ a definite intent to influence what clinicians do

Question 3

Goal of clinical practice guidelines

Answer 3

Enhance clinician and pt decision making by clearly describing and appraising the scientific evidence and reasoning behind clinical recommendations, making them relevant to the individual pt encounter

Question 4

Where are CPGs on the evidence hierarchy?

Answer 4

At the top w/ systematic reviews and critically appraised topics (if the CPG is good quality)

Question 5

CPG challenges

Answer 5

• Quality of evidence
• Reliance on expert opinion
• Difficulties involved in customizing population-based recommendations to individual px
• Lack of transparency, conflicts of interest
• Inevitably become out of date

Question 6

What does the AGREE collaboration define quality of guidelines based on?

Answer 6

• The potential biases of guideline development have been addressed adequately
• Recommendations are both internally and externally valid
• Feasible for practice

Question 7

Who are the target audience of the AGREE collaboration?

Answer 7

• HCPs (assessing quality of guidelines they follow)
• Guideline developers
• Policy makers
• Educators (enhance critical appraisal skills)

Question 8

What are the domains of the AGREE collaboration?

Answer 8

• Scope and purpose
• Stakeholder development
• Rigour of development
• Clarity of presentation
• Applicability
• Editorial independence

Question 9

Describe “scope and purpose” domain

Answer 9

• Overall objectives of guideline are specifically described
• Health question covered by guideline is specifically described
• Population to whom the guideline is meant to apply to is specifically described

Question 10

Describe “stakeholder involvement” domain

Answer 10

• Guideline development group includes individuals from all relevant professional groups
• Views and preferences of the target population have been sought
• Target users are clearly defined

Question 11

Describe “rigour of development” domain

Answer 11

• Health benefits, SE, and risks have been considered in formulating recommendations
• Explicit link between recommendations and supporting evidence
• Procedure for updating the guideline is provided

Question 12

What is the difference between level A evidence and class 1 recommendations?

Answer 12

• Level A = recommendation based on evidence from multiple randomized trials or meta-analyses
• Class 1 = conditions for which there is evidence and/or general agreement that a given procedure or tx is useful and effective

Question 13

Describe “clarity of presentation” domain

Answer 13

• Recommendations are specific and umabiguous
• Different options for management of the condition or health issue are clearly presented
• Key recommendations are easily identifiable

Question 14

Describe “applicability” domain

Answer 14

• Guideline provides advice and/or tools on how the recommendations can be put into practice
• Potential resource implications of applying the recommendations have been considered

Question 15

Describe “editorial independence” domain

Answer 15

• Views of funding body have no influenced content of guideline
• Competing interests of guideline development group members have been recorded and addressed