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Practice Guidelines
Appraisal Guide


Using a Practice Guideline

A practice guideline is a systematically developed statement designed to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.

Levels of Recommendation
(Canadian Task Force on the Periodic Health Examination)

A1: RCTs, no heterogeneity, CIs clear threshold NNT
A2: RCTs, no heterogeneity, CIs cross threshold NNT
B1: RCTs, heterogeneity, CIs clear threshold NNT
B2: RCTs, heterogeneity, CIs cross threshold NNT
C1: Observational studies, CIs clear threshold NNT
C2: Observational studies, CIs cross threshold NNT


Questions to Ask Yourself

Are the results valid?

1. Were all important options and outcomes specified?

2.Was an explicit and sensible process used to identify, select and combine the evidence?

3. Was an explicit and sensible process used to consider the relative value of different outcomes?

4. Were important recent developments included?

5. Has the guideline had peer review and testing?


What are the recommendations?

1.Are practical, important recommendations made?

2. How strong are the recommendations?

3. Could the uncertainty in the evidence or values change the guideline's recommendations


Will the results help me in patient care?

1. Is the objective of the guideline consistent with mine?

2.Are the recommendations applicable to my patients?

3.Did the study have a sufficiently large sample size?

Vanderbilt- Power and Sample Size Calculator


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