clinical practice guidelines
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2022 ◽  
Vol 28 (1) ◽  
pp. 28-42
Tae-Geun Gweon ◽  
Yoo Jin Lee ◽  
Kyeong Ok Kim ◽  
Sung Kyun Yim ◽  
Jae Seung Soh ◽  

Akira Iwanaga ◽  
Atsushi Utani ◽  
Yuta Koike ◽  
Yumi Okubo ◽  
Yutaka Kuwatsuka ◽  

PM&R ◽  
2022 ◽  
Timothy J. Olivier ◽  
Becky Baltich Nelson ◽  
Tri Pham ◽  
Kavita Trivedi ◽  
Ankit Patel ◽  

2022 ◽  
Takao Itoi ◽  
Shomei Ryozawa ◽  
Akio Katanuma ◽  
Hiroki Kawashima ◽  
Eisuke Iwasaki ◽  

2022 ◽  
Vol 30 (1) ◽  
Ben Csiernik ◽  
Ali Smith ◽  
Joshua Plener ◽  
Anthony Tibbles ◽  
James J. Young

Abstract Background Despite numerous low back pain (LBP) clinical practice guidelines, published studies suggest guideline nonconcordant care is still offered. However, there is limited literature evaluating the degree to which chiropractors, particularly students, follow clinical practice guidelines when managing LBP. The aim of this study was to evaluate the frequency of use of specific interventions for LBP by students at a chiropractic teaching clinic, mapping recommended, not recommend, and without recommendation interventions based on two clinical practice guidelines. Methods This was a retrospective chart review of patients presenting to the Canadian Memorial Chiropractic College teaching clinic with a new complaint of LBP from January to July 2019. Interventions provided under treatment plans for each patient were extracted. Interventions were classified as recommended, not recommended, or without recommendation according to two guidelines, the NICE and OPTIMa LBP guideline. Results 1000 patient files were identified with 377 files meeting the inclusion criteria. The most frequent interventions provided to patients were manipulation/mobilization (99%) and soft tissue therapy (91%). Exercise, localized percussion, and advice and/or education were included in just under half of the treatment plans. Patient files contained similar amounts of recommended (70%) and not recommended (80%) interventions according to the NICE guideline classification, with half the treatment plans including an intervention without recommendation. Under the OPTIMa acute guideline, patient files contained similar amounts of recommended and not recommended care, while more recommended care was provided than not recommended under the OPTIMa chronic guideline. Conclusions Despite chiropractic interns providing guideline concordant care for the majority of LBP patients, interventions classified as not recommended and without recommendation are still frequently offered. This study provides a starting point to understand the treatment interventions provided by chiropractic interns. Further research should be conducted to improve our understanding of the use of LBP guideline recommended care in the chiropractic profession. Trial registration Open Science Framework # g74e8.

Christoffer Bruun Korfitsen ◽  
Marie-Louise Kirkegaard Mikkelsen ◽  
Anja Ussing ◽  
Karen Christina Walker ◽  
Jeanett Friis Rohde ◽  

The Danish Health Authority develops clinical practice guidelines to support clinical decision-making based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and prioritizes using Cochrane reviews. The objective of this study was to explore the usefulness of Cochrane reviews as a source of evidence in the development of clinical recommendations. Evidence-based recommendations in guidelines published by the Danish Health Authority between 2014 and 2021 were reviewed. For each recommendation, it was noted if and how Cochrane reviews were utilized. In total, 374 evidence-based recommendations and 211 expert consensus recommendations were published between 2014 and 2021. Of the 374 evidence-based recommendations, 106 included evidence from Cochrane reviews. In 28 recommendations, all critical and important outcomes included evidence from Cochrane reviews. In 36 recommendations, a minimum of all critical outcomes included evidence from Cochrane reviews, but not all important outcomes. In 33 recommendations, some but not all critical outcomes included evidence from Cochrane reviews. Finally, in nine recommendations, some of the important outcomes included evidence from Cochrane reviews. In almost one-third of the evidence-based recommendations, Cochrane reviews were used to inform clinical recommendations. This evaluation should inform future evaluations of Cochrane review uptake in clinical practice guidelines concerning outcomes important for clinical decision-making.

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