Clinical Practice Guidelines in Psychiatry: More Confusion Than Clarity? A Critical Review and Recommendation of a Unified Guideline

The discipline of psychiatry has a plethora of guidelines, designed to serve the needs of the clinician. Yet, even a cursory glance is enough to discern the differences between the various guidelines. This paper reviews the current standard guidelines being followed across the world and proposes a unified guideline on the backbone of current evidence and practice being followed. The algorithm for pharmacological and psychosocial treatment for bipolar disorder, major depressive disorder, and schizophrenia is formulated after cross-comparison across four different guidelines and recent meta-analytical evidence. For every disorder, guidelines have different suggestions. Hence, based on the current status of evidence, algorithms have been combined to form a unified guideline for management. Clinical practice guidelines form the basis of standard clinical practice for all disciplines of medicine, including psychiatry. Yet, they are often not read or followed because of poor quality or because of barriers to implementation due to either lack of agreement or ambiguity. A unified guideline can go a long way in helping clear some of the confusion that has crept in due to the use of different guidelines across the world.

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Systematic review of clinical practice guidelines for adults with fractures: identification of best evidence for rehabilitation to develop the WHO’s Package of Interventions for Rehabilitation

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-020-00560-w ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Francesca Gimigliano ◽

◽

Sara Liguori ◽

Antimo Moretti ◽

Giuseppe Toro ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Hip Fracture ◽

Distal Radius ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Adult Population ◽

World Health ◽

The World

Abstract Background The identification of existing rehabilitation interventions and related evidence represents a crucial step along the development of the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR). The methods for such identification have been developed by the WHO Rehabilitation Programme and Cochrane Rehabilitation under the guidance of the WHO’s Guideline Review Committee secretariat. The aim of this paper is to report on the results of the systematic search for clinical practice guidelines (CPGs) relevant to the rehabilitation of adults with fractures and to present the current state of evidence available from the identified CPGs. Methods This paper is part of the Best Evidence for Rehabilitation (be4rehab) series, developed according to the methodology presented in the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR) introductory paper. It is a systematic review of existing CPGs on fractures in adult population published from 2009 to 2019. Results We identified 23 relevant CPGs after title and abstract screening. According to inclusion/exclusion criteria, we selected 13 CPGs. After checking for quality, publication time, multiprofessionality, and comprehensiveness, we finally included five CPGs dealing with rehabilitative management of fractures in adult population, two CPGs addressing treatment of distal radius fracture and three the treatment of femoral/hip fracture. Conclusion The selected CPGs on management of distal radius and femoral/hip fracture include few recommendations regarding rehabilitation, with overall low to very low quality of evidence and weak/conditional strength of recommendation. Moreover, several gaps in specific rehabilitative topics occur. Further high-quality trials are required to upgrade the quality of the available evidence. Level of evidence Level 1.

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Adapted clinical practice guidelines on heart failure for family physicians: A collaborative project of the World Health Organization and Iranian Ministry of Health and Medical Education

Heart Lung and Circulation ◽

10.1016/j.hlc.2007.11.017 ◽

2008 ◽

Vol 17 ◽

pp. S7

Author(s):

Behnood Bikdeli ◽

Shadi Kalantarian ◽

Maryam Sadeghian ◽

Fereydoon Nouhi ◽

Mohammad Reza Motamedi ◽

...

Keyword(s):

Heart Failure ◽

Medical Education ◽

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Family Physicians ◽

World Health ◽

Collaborative Project ◽

The World ◽

Health Organization

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The Poor Quality of Clinical Practice Guidelines

Ear Nose & Throat Journal ◽

10.1177/014556139907800701 ◽

1999 ◽

Vol 78 (7) ◽

pp. 462-462

Author(s):

Jack L. Pulec

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Poor Quality ◽

The Poor

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Ehlers-Danlos syndromes: state of the art on clinical practice guidelines

RMD Open ◽

10.1136/rmdopen-2018-000790 ◽

2018 ◽

Vol 4 (Suppl 1) ◽

pp. e000790 ◽

Cited By ~ 8

Author(s):

Alberto Sulli ◽

Rosaria Talarico ◽

Carlo Alberto Scirè ◽

Tadej Avcin ◽

Marco Castori ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Clinical Decision Making ◽

Unmet Needs ◽

Musculoskeletal Diseases ◽

Clinical Decision ◽

Current Evidence ◽

Reference Network ◽

Publication Type

ObjectiveTo report the effort of the European Reference Network for Rare and Complex CONnective tissue and musculoskeletal diseases NETwork working group on Ehlers-Danlos syndromes (EDS) and related disorders to assess current available clinical practice guidelines (CPGs) specifically addressed to EDS, in order to identify potential clinician and patient unmet needs.MethodsSystematic literature search in PUBMED and EMBASE based on controlled terms (MeSH and Emtree) and keywords of the disease and publication type (CPGs). All the published articles were revised in order to identify existing CPGs on diagnosis, monitoring and treatment of EDS.ResultsLiterature revision detected the absence of papers reporting good quality CPGs to optimise EDS patient care. The current evidence-based literature regarding clinical guidelines for the EDS was limited in size and quality, and there is insufficient research exploring the clinical features and interventions, and clinical decision-making are currently based on theoretical and limited research evidences.ConclusionsMany clinician and patient unmet needs have been identified.

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Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome

Intensive Care Medicine ◽

10.1007/s00134-013-2906-z ◽

2013 ◽

Vol 39 (7) ◽

pp. 1190-1206 ◽

Cited By ~ 643

Author(s):

Andrew W. Kirkpatrick ◽

◽

Derek J. Roberts ◽

Jan De Waele ◽

Roman Jaeschke ◽

...

Keyword(s):

Clinical Practice ◽

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

World Society ◽

Abdominal Hypertension ◽

The World ◽

Abdominal Compartment

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Guidelines for Cancer Care during the COVID-19 Pandemic in South Korea

Cancer Research and Treatment ◽

10.4143/crt.2020.1256 ◽

2021 ◽

Vol 53 (2) ◽

pp. 323-329

Author(s):

Jii Bum Lee ◽

Minkyu Jung ◽

June Hyuk Kim ◽

Bo Hyun Kim ◽

Yeol Kim ◽

...

Keyword(s):

Clinical Practice ◽

Severe Acute Respiratory Syndrome ◽

Cancer Patients ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Cancer Care ◽

Task Force ◽

World Health ◽

The World ◽

Health Organization

At the end of 2019, the cause of pneumonia outbreaks in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In February 2020, the World Health Organization named the disease cause by SARS-CoV-2 as coronavirus disease 2019 (COVID-19). In response to the pandemic, the Korean Cancer Association formed the COVID-19 task force to develop practice guidelines. This special article introduces the clinical practice guidelines for cancer patients which will help oncologists best manage cancer patients during the COVID-19 pandemic.

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BRIDGING THE TRANSLATION GAP: FROM DEMENTIA RISK ASSESSMENT TO ADVICE ON RISK REDUCTION

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2015.75 ◽

2015 ◽

pp. 1-10

Author(s):

K.J. Anstey ◽

R. Eramudugolla ◽

D.E. Hosking ◽

N.T. Lautenschlager ◽

R.A. Dixon

Keyword(s):

Risk Assessment ◽

Clinical Practice ◽

Risk Reduction ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Academic Research ◽

Current Evidence ◽

Factors Associated ◽

Dementia Risk ◽

Present Information

Dementia risk reduction is a global health and fiscal priority given the current lack of effective treatments and the projected increased number of dementia cases due to population ageing. There are often gaps among academic research, clinical practice, and public policy. We present information on the evidence for dementia risk reduction and evaluate the progress required to formulate this evidence into clinical practice guidelines. This narrative review provides capsule summaries of current evidence for 25 risk and protective factors associated with AD and dementia according to domains including biomarkers, demographic, lifestyle, medical, and environment. We identify the factors for which evidence is strong and thereby especially useful for risk assessment with the goal of personalising recommendations for risk reduction. We also note gaps in knowledge, and discuss how the field may progress towards clinical practice guidelines for dementia risk reduction.

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Stroke Rehabilitation and Patients with Multimorbidity: A Scoping Review Protocol

Journal of Comorbidity ◽

10.15256/joc.2015.5.47 ◽

2015 ◽

Vol 5 (1) ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Michelle L.A. Nelson ◽

Linda Kelloway ◽

Deirdre Dawson ◽

J. Andrew McClure ◽

Kaileah A. McKellar ◽

...

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Stroke Rehabilitation ◽

Mixed Methods Research ◽

Best Practice ◽

Healthcare Delivery ◽

Stroke Care ◽

Current Evidence ◽

Medical Diagnoses

Stroke care presents unique challenges for clinicians, as most strokes occur in the context of other medical diagnoses. An assessment of capacity for implementing “best practice” stroke care found clinicians reporting a strong need for training specific to patient/system complexity and multimorbidity. With mounting patient complexity, there is pressure to implement new models of healthcare delivery for both quality and financial sustainability. Policy makers and administrators are turning to clinical practice guidelines to support decision-making and resource allocation. Stroke rehabilitation programs across Canada are being transformed to better align with the Canadian Stroke Strategy's Stroke Best Practice Recommendations. The recommendations provide a framework to facilitate the adoption of evidence-based best practices in stroke across the continuum of care. However, given the increasing and emerging complexity of patients with stroke in terms of multimorbidity, the evidence supporting clinical practice guidelines may not align with the current patient population. To evaluate this, electronic databases and gray literature will be searched, including published or unpublished studies of quantitative, qualitative or mixed-methods research designs. Team members will screen the literature and abstract the data. Results will present a numerical account of the amount, type, and distribution of the studies included and a thematic analysis and concept map of the results. This review represents the first attempt to map the available literature on stroke rehabilitation and multimorbidity, and identify gaps in the existing research. The results will be relevant for knowledge users concerned with stroke rehabilitation by expanding the understanding of the current evidence.

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