Clinical Practice Guidelines (CPG) are graded recommendations on bestpractice for a specific condition based on the systematic review and evaluation of the quality of the scientific literature. These documents are defined by a stringent methodology and formal process for development. Clinical practice guidelines are required to bridge the gap between evidence and recommendation and are made up of both evidence-based and expert-based information to guide clinical practice decision-making. Although variation can exist, all must meet standard criteria. The Director of Practice works with the CPG Advisory Committee to identify CPG topics, formulate CPG work groups, and ensures that a rigorous process is utilized to create the CPG.
Members of the Task Force included:
- Tim Hanke, PT, PhD (Chair)
- Amber Devers, PT, DPT, NCS
- Michelle Lusardi, PT, DPT, PhD
- Shree Pandya, PT, DPT, MS
- Amelia Siles, PT, DPT, NSC
- Irene Ward, PT, DPT, NCS
The document entitled, “Neurology Section Procedures for Evidence-Based Document Development” was completed by the Task Force and approved by the Academy of Neurologic Physical Therapy Board in April of 2015.
The Neurology Section Procedures for Evidence-Based Document Development largely focuses on clinical practice guideline development. However, as the Task Force initiated its work, it became clear that there are a number of evidence-based documents that could be used to advance the practice of neurologic physical therapy. As a result, the document was expanded to include other types of evidence-based documents. Comments on the other types of evidence-based documents are included throughout, particularly under scope and critical appraisal.
The Neurology Section Procedures for Evidence-Based Document Development is intended to be informational and useful to anyone responsible for evidence-based document development. This document defines the different types of evidence-based documents, describes a potential structure for evidence-based document development, and identifies roles and responsibilities of workgroup members and reporting relationships to the Academy of Neurologic Physical Therapy BOD members. This document also addresses conflict of interest, topic identification, scope, the critical appraisal process, data extraction and synthesis of findings, formulating recommendations, revision and implementation of evidence-based documents.
This document may be useful to anyone interested in learning more about the development of evidence-based documents. Please note, some content may not apply to other Academy/users, simply because the document was drafted with Academy of Neurologic Physical Therapy’s structure and goals in mind. This guide to the development of evidence-based documents is applicable for the next five years and should be updated as methodology evolves in the field. For example, the implementation section is discussed in general terms, but implementation science is a rapidly evolving field. In time, more specific recommendations for effectively implementing evidence-based recommendations will likely exist. Also, data storage sites and software that assists in data extraction, appraisal and synthesis are evolving and becoming more user-friendly.
In creating this document, the Task Force borrowed from a number of important resources that are acknowledged here:
Annual APTA Workshop on Clinical Practice Guideline Development led by Sandra Kaplan and Joseph Godges;
Rosenfeld et al, 2013, Clinical Practice Guideline Development Manual, Third Edition: A Quality-Driven Approach for Translating Evidence into Action: Head and Neck Surgery, 148(1S) S1–S55;
Gronseth et al, 2011,Clinical Practice Guideline Process Manual, Academy of Neurology;
Kaplan et al, 2013, Developing Evidence-Based Physical Therapy Clinical Practice Pediatr Phys Ther;25:257–270;
Fetters & Tilson, 2012, Evidence Based Physical Therapy, FA Davis;
Graham et al, 2006, Lost in knowledge translation: time for a map? J Contin Educ Health Prof.26:13–24.;
Geriatric EDGE Task Force;
Orthopedic Section’s Clinical Practice Guidelines.
Acknowledgements: The Academy of Neurologic Physical Therapy CPG Task Force acknowledges Patty Scheets, Beth Crowner, and members of the Neurology Board for their leadership, support, revision, and approval of the final document.
If there are any questions or comments please contact the Academy of Neurologic Physical Therapy Director of Practice, Beth Crowner.