Clinical Practice Guidelines (CPGs)
Introduction and background
Clinical Practice Guidelines (CPGs) are systematically developed statements that can help clinicians decide on the best care for their patients. It must be emphasized that CPGs should never substitute for the clinician's knowledge of patient specific presentations, diagnoses, and treatment. CPGs must be created and evaluated in a rigorous, transparent manner to earn the confidence of the profession and the public.
The development and use of clinical practice guidelines (CPGs) is a common objective for a wide range of health care disciplines. Competing priorities for the busy clinician may lead to gaps between the best available evidence and actual patient care practice. CPGs are intended to help close those gaps to reduce inappropriate practice variation, enhance translation of research into practice, and improve healthcare quality and safety. The development and endorsement of CPGs is an important method of translating knowledge to practice by guiding clinical decision-making aimed at accepting optimal patient outcomes.
To promote the advancement of the Orthotic and Prosthetic profession the Academy has established the Clinical Practice Guideline Program which consists of two distinct pathways: 1) New CPGs will be created from a prioritized topic list that will provide the most benefit to the profession. 2) The Academy recognizes that CPGs developed by other groups within the O&P profession or in a related field may be of benefit to the O&P community. Thus, existing CPGs may be selected to undergo the Academy's endorsement process. The documents below in Sections 1 and 2 detail the dual processes of creating new CPGs and alternately, endorsing existing CPGs.
The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument plays a prominent role in both the Academy's CPG Establishment process and the Academy's Endorsement process. The AGREE evaluates the process of practice guideline development and the quality of reporting. The AGREE II is an international tool for the assessment of practice guidelines. The AGREE II is both valid and reliable and comprises 23 items organized into 6 quality domains. The document immediately below provides the reader with a checklist corresponding to the 23 items in the AGREE II instrument. For further information visit the AGREE II website at www.agreetrust.org
The Academy's CPG Establishment process involves selection of the CPG topic, completion of the Systematic/Scoping Review, identification of the Guideline Development Group including the Chair and Vice-Chair, development of postulates, convening of a Panel of Experts, the use of the Modified Delphi approach to achieve consensus on the postulates, development of the Guidelines, review of the Guidelines by a team representing the State of the Science Program Committee, and finally the decision by the Academy Board of Directors to determine whether to publish the CPG document. Click below for more information regarding the Academy's CPG Establishment process.
Process for the Establishment of Clinical Practice Guidelines
Entities that have developed CPGs on orthotic and prosthetic care topics may seek the Academy's endorsement. The process for achieving this endorsement of an existing CPG includes submitting specific materials to the Academy and an assessment process that includes using the AGREE II instrument by an interdisciplinary review team to help determine if the CPG is suitable for Academy endorsement. Click the link below to view the Academy's CPG Endorsement Process details.
The State of the Science Program Committee (SSPC) oversees the development and endorsement of CPGs for the Academy. If you have any questions regarding the Academy's Clinical Practice Guideline Program, or if you are interested in submitting a CPG for endorsement by the Academy, please contact the Academy at: SSPC@Oandp.org
Process for Clinical Practice Guideline Endorsement
The Academy is dedicated to developing new Clinical Practice Guidelines (CPGs) related to orthotics and prosthetics and reviewing existing ones for possible endorsement. CPGs provide patient care recommendations and assess possible benefits and harms based on the information provided in a systematic review and expert opinion through a modified Delphi consensus process. They are meant to bridge the gap between researchers and clinicians to facilitate such research findings into clinical practice.
Clinical Practice Guidelines Endorsement Process
The Academy may provide expert feedback during development and/or consider endorsing a completed CPG. Ideally, the Academy has been able to provide feedback during the development process before being asked to consider endorsing it. This process is intended for authors outside the Academy who may or may not be members of the Academy but who wish to receive feedback or endorsement of their CPG. Instructions for requests for feedback or endorsement may be found here.
| Academy Endorsed Clinical Practice Guidelines | Date Published | Author |
|---|---|---|
| A Clinical Practice Guideline for the Use of Ankle Foot Orthoses and Functional Electrical Stimulation Post Stroke | 4/2021 | Therese E. Johnston, PT, MSPT, PhD, MBA; Sarah Keller, PT, DPT; Caitlin Denzer-Weiler, PT, DPT; Lisa Brown, PT, DPT |
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