Steps to develop clinical practice guidelines

1. Steps to develop clinical practice
guidelines

2. • Clinical practice guidelines are recommendations for clinicians about
the care of patients with specific conditions. They should be based
upon the best available research evidence and practice experience.
This topic will provide an overview of practice guidelines. Links to
society and government-sponsored guidelines from selected
countries and regions around the world are provided separately

4. • The first step in creating a CPG is to identify critical knowledge gaps
and define the clinical problem, the scope and the target audience.
Selected topics should be both “high-priority” and feasible.14 The
development of a CPG is considered “high-priority” if there is,

5. Significant disease burden and cost of management
Controversy or uncertainty around the topic and supporting evidence
New evidence arising that may impact current recommendations
Potential to improve health outcomes and quality of life, reduce mortality and morbidity, and affect decision making
Public or provider interest
Potential to reduce variations in care and cost.
Furthermore, proposed topics must have clear definitions of the disease or the procedure of interest and there must be an adequate evidence base to inform the recommendations.

6. • The need for a CPG can also be evaluated by surveying key stakeholder groups. For example, Nater et al conducted a survey of the shoulder
impingment International community to assess whether members would benefit from a CPG outlining how to manage perioperative neurologic
deficit during shoulder surgery. The survey also aimed to gauge the likelihood that surgeons would use this guideline in their clinical practice.
Information from surveys can be used to prioritize topics for CPGs, evaluate current practice standards, and initiate the process of knowledge
translation.
• According to researcher MARTIN J. KELLEY, DPT • MICHAEL A. SHAFFER the purposes of these clinical guidelines are to:
• • Describe evidence-based physical therapy practice, including diagnosis, prognosis, intervention, and assessment of outcome, for musculoskeletal
disorders commonly managed by orthopaedic physical therapists
• • Classify and define common musculoskeletal conditions using the World Health Organization’s terminology related to impairments of body function
and body structure, activity limitations, and participation restrictions
• • Identify interventions supported by current best evidence to address impairments of body function and structure, activity limitations, and
participation restrictions associated with common musculoskeletal conditions
• • Identify appropriate outcome measures to assess changes resulting from physical therapy interventions in body function and structure as well as in
activity and participation of the individual
• • Provide a description to policy makers, using internationally accepted terminology, of the practice of orthopaedic physical therapists
• • Provide information for payers and claims reviewers regarding the practice of orthopaedic physical therapy for common musculoskeletal conditions
• • Create a reference publication for orthopaedic physical therapy clinicians, academic instructors, clinical instructors, students, interns, residents, and
fellows regarding the best current practice of orthopaedic physical therapy.
•

7. • PROS AND CONS OF CPG WHILE APPLYING TO THE PATIENT
•
• Eventhough the use of guidelines in the treatment of patients has led to a
reduction of cardiovascular events in comparison with patients where
guidelines were not applied, as a rule guidelines are not widely used in
clinical practice.But why does this happen? Is it the result of physicians’
non-compliance because of a lack of knowledge, or are the guidelines
themselves difficult to apply?Guidelines have certain advantages, but also
serious disadvantages, of which the physician should be well aware. Here, I
am summarise the pros and cons of guidelines and suggest ways in which
they could be improved with support from recent evidence based.
• The pros of guidelines