Clinical Practice Guidelines

Question 1

“Statements that include recommendations intended to optimize patient care. They are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.”

Answer 1

Clinical Practice Guidelines

Question 2

CPGs reflect findings from ________, as well as expert clinical judgment and health care consumer opinion or perspective.

Answer 2

best evidence

Question 3

Two formats of CPG.

Answer 3

Healthcare professional & general public

Question 4

Primary source for CPG.

Answer 4

Agency for Healthcare Research and Quality

AHRQ

Question 5

Give an example of a CPG entailing the management of conditions.

Answer 5

Guideline for stroke rehabilitation and recovery.

Question 6

“ATS statement: guidelines for the 6-minute walk test” is an example of an __________.

Answer 6

Agency for Healthcare Research and Quality

AHRQ

Question 7

Where can we locate CPGs?

Answer 7

➤ PubMed (by U.S. National Library of Medicine)
➤ Physiotherapy Evidence Database (PEDro)
➤ www.guideline.gov (by AHRQ)
➤ PTNow (by American Physical Therapy Association)

Question 8

T or F

The second step in creating an evidence based CPG is to identify and refine the topic and scope of the CPGs.

Answer 8

F (First step…)

Question 9

T or F

In creating evidence based CPG, one needs to identify and convene the appropriate stakeholders—such as clinicians, patients, caregivers, researchers, and technical support staff—to participate.

Answer 9

T

Question 10

Conducting a systematic review of the evidence is the third step in creating evidence based CPG.

Answer 10

T

Question 11

(4) Develop recommendations based on the _____, as interpreted by clinical expertise and patient experience, as well as on feasibility issues such as
cost.

Answer 11

systematic review

Question 12

This is the last step in creating evidence based CPG.

Answer 12

Submit the CPG for external review

Question 13

T or F

Evidence from at least one other type of quasi-experimental study is classified as 2b under the Category of Evidence.

Answer 13

T

Question 14

Evidence for meta-analysis of randomized controlled trials is classified as 1b under the Category of Evidence.

Answer 14

F (1a)

Question 15

Evidence from at least one randomized controlled trial is classified as 1b under the Category of Evidence.

Answer 15

T

Question 16

Evidence from nonexperimental descriptive studies (comparative studies, correlation studies, and case-control studies) ranks as 2a under the Category of Evidence.

Answer 16

F (3)

Question 17

Evidence from at least one controlled study without randomization.

Answer 17

Classified as 2a

Question 18

This is the lowest rank under the Category of Evidence (4).

Answer 18

Evidence from expert committee reports or opinions or clinical experience of respected authorities or both.

Question 19

_____ quality of evidence is characterized by further research being very unlikely to change the confidence in the estimate of effect.

Answer 19

High

Question 20

T or F

Low quality of evidence is characterized by further research being likely to have an important impact on the confidence in the estimate of effect and may change the estimate.

Answer 20

F (Moderate)

Question 21

_______ quality of evidence is characterized by any estimate of effect being very uncertain.

Answer 21

Very low

Question 22

_____ quality of evidence is characterized by further research being very likely to have an important impact on the confidence in the estimate of effect and is likely to change the estimate.

Answer 22

Low

Question 23

This are the questions that the appraisal aims to answer.

Answer 23

Is the guideline VALID?

Is the Guideline applicable?

Question 24

Due to the introduction of new patient/client management techniques, there is a possibility that CGPs may become _____.

Answer 24

outdated

Question 25

Give 4 reasons why CPGs may become outdated (Shekelle et al. 2001).

Answer 25

1. New evidence clarifying beneficial or harmful consequences of current patient/client management techniques.
2. Changes in which outcomes of care are considered important clinically and socially.
3. Full compliance with current CPGs, thus no longer necessitating their use.
4. Changes in health care resources

Question 26

CPGs should be reviewed every ____ and updated as

necessary

Answer 26

3 years

Question 27

_____ should consider whether the age of the product makes its application unreasonable or inappropriate in the current practice environment.

Answer 27

EBPTs

Question 28

T or F

According to Hasenfeld & Shekelle, older CPGs did not meet most of the quality criteria.

Answer 28

F (newer)

Question 29

International standard for reporting the development and evaluation of CPGs.

Answer 29

Appraisal of Guidelines Research and Evaluation Collaboration (AGREE) II,
2010

Question 30

Give the 6 Domains of AGREE II.

Answer 30

1. Scope and purpose
2. Stakeholders involvement
3. Rigor of development
4. Clarity and presentation
5. Applicability
6. Editorial independence

Question 31

______: high prevalence rate, seriousness of the

consequences

Answer 31

Impact

Question 32

The condition of interest covered by the CPG should have ______.

Answer 32

enough impact

Question 33

The decision to implement the guideline depends on the ______ of its recommendations, which is achieved by use of particular patient/client management techniques.

Answer 33

specificity

Question 34

Physical therapists must consider the _____ between a CPGs recommendations and the individual patient or client’s preference and values.

Answer 34

congruence

Question 35

T or F

If the anticipated outcomes are only incrementally
better than current practice, then adoption of the CPG
may not be worthwhile

Answer 35

T

Question 36

Adoption of CPG should be considered in terms of the ______ relative to the investment made.

Answer 36

outcomes achieved

Question 37

Successful CPG implementation depends on the _______ of those involved to change their current behaviors and practice.

Answer 37

willingness

Question 38

What are potential barriers to change?

Answer 38

Provider preferences,

habits, and concerns regarding the loss of autonomy.