Clinical Practice Guidelines (CPGs)
In June, 2010, the CNSF Board of Directors created a Practice Guidelines (PG) Committee to develop recommendations on how to deal with requests to endorse best-practice guidelines. On November 02, 2010, the PG Committee affirmed that the endorsement of Clinical Practice Guidelines is an appropriate role for the CNSF and considered a set of criteria and processes that had been drafted based on the principles and policies developed by the Canadian Stroke Network for its “Stroke Strategy”.
The Practice Guidelines Committee concluded that under present circumstances, the most feasible role for the CNSF and its constituent Societies will be to encourage and support the development of best-practice guidelines by other groups such the Affiliate Societies and, if requested, to consider the endorsement of these guidelines, recognizing that:
- Clinical Practice Guidelines are being increasingly used by policy-makers, accreditation bodies, and governments as well as clinicians,
- The processes for developing best-practice guidelines have evolved from being consensus documents prepared by “experts” to guidelines based on evidence-based analyses and qualitative grading techniques,
- Endorsement of practice guidelines by the CNSF and/or the constituent Societies will require a process that takes into account these contemporary standards for guidelines development and implementation.
The CPGC is made up from a cross section of the CNSF including representation from the CNSF Executive Committee, at least one member from each Society, the CNSF Advocacy Committee Chair, and at least one residents’ representative. Other CPGC members are drawn from each of the CNSF Associate Societies and, as required from the Affiliate Societies.
The CPGC is accountable to the CNSF Board, to whom it must report twice yearly.
The Clinical Practice Guidelines Committee will:
Consider for endorsement Clinical Practice Guidelines that have been prepared by inter-professional groups of sub-specialized neurologists, neurosurgeons and/or other clinical neuroscience practitioners in accordance with current evidence-based criteria for the preparation of guidelines.
Publish its current criteria for approving clinical practice on the CNSF web-site and review its criteria and processes at least every two years.
Consult with appropriate specialists to support the effective implementation of new policies and practices through strategies of “knowledge transfer” that include the rationale for the recommendation, key health system implications, standardized performance measures to evaluate implementation and a summary of the supporting evidence to ensure that the best-practice guidelines endorsed by the CNSF have their optimum impact.
Encourage the submission of CNSF-endorsed guidelines for publication in either the Canadian Medical Association Journal (CMAJ) or the Canadian Journal of Neurological Sciences (CJNS) in both English and in French to promote the widest possible distribution of endorsed practice guidelines to Canadian practitioners and policy-makers.
Consult annually with the professional group (usually one of the Affiliate Societies) that originally submitted the guidelines to determine if there is a need for revisions to ensure that the recommendations endorsed by the CNSF are kept up-to-date.
Review periodically the processes followed to consider submitted practice guidelines for endorsement as well as the role of the CNSF in guidelines development.
When considering the endorsement of Clinical Practice Guidelines the committee reviews with the following criteria in mind:
Inter-professional involvement in preparation of guidelines
Have the CPGs been prepared by inter-professional groups of sub-specialized neurologists, neurosurgeons and/or other clinical neuroscience practitioners, most of whom will be members of the Affiliate or Associate Societies of the CNSF committed to regular practice guidelines evaluation and adaptation cycles?
Review of evidence-based recommendations
Are the CPGs supported by an extensive review of international research and published evidence-based best practice recommendations or guidelines related to a specific neurological condition?
Current criteria (e.g. AGREE II) used in the preparation
Have been prepared in accordance with current evidence-based criteria for the preparation of guidelines (e.g. references in Vachhrajani et al., 2009; see also AGREE II; AGREE Research Trust www.agreetrust.org)?
Address the continuum of care for specific disorders
Address, where appropriate, the continuum of care for a specific neurological condition, recognizing that some narrowly-focused guidelines may only apply to a restricted segment of continuum of care.
The "continuum of care" includes: primary prevention, health promotion and public awareness, hyperacute management, acute management, rehabilitation, prevention of recurrence (secondary prevention).
Will serve as a frame-work for other jurisdictions (e.g. provinces, territories)
Will the CPGs serve as a framework for provinces and territories as they develop and implement strategies to address the needs of affected populations?
Documented external review by content and methods experts
Was documentation included with the CPGs demonstrating an external group of content and methods experts have conducted a final review of the recommendations?
Plans for implementation outlined
Was documentation Included with the CPGs sharing plans for the effective implementation of practice changes that have been prepared in accordance with contemporary principles of “knowledge mobilization” (e.g. Fixen & Blasé, 2006; Fafard, 2008)?
Ethical implications considered
What consideration for the potential ethical implications of the recommended changes in practice was conducted?
2013
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Insert Company Name
2012
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