Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - 3
CLINICAL PRACTICE GUIDELINE
If the literature supporting a recommendation
comes from two or more levels, the number
and level of the studies are reported (e.g., in the
case of a recommendation that is supported by
two studies, one a level III, the other a level V the
,
"Scientific evidence" is indicated as "III/V"). In
situations in which no published literature exists,
consensus of the Panel Members and the Steering
Committee's recommended field reviewers is used
to develop the recommendation and its rationale.
The rationale section supports the
recommendation statement based on scientific
evidence.
Each Panel Member votes based on his/her
opinion on the strength of the recommendation
(i.e., a vote taken at the final panel meeting).
The level to which Panel Members agree on the
strength of each recommendation is assessed as
either low, moderate, or strong. Each Panel
Member is asked to indicate his or her level of
agreement on a 5-point scale, with 1
corresponding to neutrality and 5 representing
maximum agreement. Scores are aggregated
and an arithmetic mean is calculated. This mean
score is then translated into low, moderate, or
strong, as shown in Table 3. Panel Members may
abstain from the voting process if they lack the
expertise associated with a particular
recommendation. After the Panel votes on the
grading of the recommendation, the strength
of the opinion will be added to the document.
Table 2. Levels of Panel Agreement with the
Recommendation
Level
Mean Agreement Score
Low
Moderate
Strong
1.0-2.32
2.33-3.66
3.67-5.0
REFERENCES FOR METHODOL OGY
Cook, D. J., C. D. Mulrow, and R. B. Haynes. Systematic
reviews: Synthesis of best evidence for clinical decisions. Ann
Intern Med 126 (1997): 376-80.
Harris, R. P M. Helfand, S. H. Woolf et al. Current methods of
the U.S. Preventive Services Task Force. Am J Prev Med 20
(3S) (2001): 21-35.
Jadad, A. R., R. A. Moore, D. Carroll et al. Assessing the
quality of reports of randomized clinical trials: Is blinding
necessary? Controlled Clin Trials 17 (1996): 1-12.
Sacks, H. S., J. Berrier, D. Reitman et al. Meta analysis of
randomized controlled trials. N Engl J Med 316 (8) (1987):
450-55.
Steering Committee on Clinical Practice Guidelines for the
Care and Treatment of Breast Cancer. Can Med Assoc J 158
(3 Suppl) (1998): S1-S2.
West, S., V King, T. S. Carey et al. Systems to rate the strength
.
of scientific evidence. Evidence Report/ Technology
Assessment no. 47. Prepared by the Research Triangle
Institute-University of North Carolina Evidence Based Practice
Center under contract 290-97¬0011. AHRQ Publication no.
02-E016. Rockville, MD: Agency for Healthcare Research and
Quality, April 2002.
3
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury
Table of Contents for the Digital Edition of Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury
Contents
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - Cover1
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - Cover2
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - i
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - Contents
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - iii
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - iv
Pressure Ulcer Prevention and Treatment Following Spinal Cord Injury - v
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