What is the focus of Evidence-Based Practice Guidelines? (EBPGs)
decreasing variation in practice
(intended to optimize patient care/outcomes; include recommendations for practice/policies/research)
What is EBPGs based on
systematic review of evidence
What is the benefit to EBPGs
flexibility
what is the purpose of updating clinical practice guidelines
evolving nature of evidence
Information contained in EBPGs (7)
- expertise of guideline developers
- funders of guideline development
- thoroughness of evidence search
- strength & quality of evidence
- population for whom guideline was developed for
- methods section
- date guideline was finalized
REMEMBER “FRESH-MD”
F - funders
R - resources/research thoroughness
E - expertise
S - strength
H - health population
M - methods
D - date
Appraisal (AGREE II Instrument)
purposes (3)
- assess quality
- provide methodological strategy
- inform guideline appraisal
Appraisal (AGREE II Instrument)
the 6 domains
- scope and purpose
- stakeholder involvement
- rigor of development
- clarity and presentation
- application
- editorial independence
REMEMBER “SCRAPE”
S - scope and purpose
C - clarity and presentation
R - rigor of development
A - application
P - (participant); stakeholder involvement
E - editorial independence
Steps in EBPG development
(6)
- use a formal and explicit process
- identifying experts first
- analytic framework or causal pathway
- perform formal search and review of literature
- develop recommendations based on the strength of evidence
- perform peer review
REMEMBER: “Find Experts, Analyze, Search, Strengthen, and Review”
F - formal and explicit process
E - experts
A - analyze
S - search
S - strengthen
R - review
critical elements for successful implementation of EBPGs
- administrative support
- positive culture
- interactive education
- reminders
- electronic systems
- prioritizing interventions
- critically appraise prior to implementing
REMEMBER “PRIME-CAP”
P - positive culture
R - reminders
I - interactive education
M - methods (electronic system)
E - education
C - critically appraise
A - administrative support
P - prioritizing interventions
