External Evidence-Based Guidelines and Other Resources

Evidence-Based Guides for Practice recommendations are largely based on the summarized evidence from the analysis on the Evidence Analysis Library (EAL). The recommendations are rated using the EAL Recommendations Rating Scale and include links to the conclusion statements, evidence summaries and worksheets. At times, the expert workgroup for an EAL project may determine that the EAL may be strengthened and broadened by using external (non-Academy) evidence-based guidelines or other credible resources in developing the recommendations.

External guidelines and other resources can be incorporated into EAL recommendations in 2 ways:
  • Credible resources may serve as a reference for a Consensus recommendation
  • External guidelines may serve as evidence analysis for Evidence-Based recommendations (either as a replacement for our own evidence analysis or in addition to our own evidence analysis) and receive a strength rating (as long their evidence analysis methodology is considered comparable to that used by the Academy).

Credible Resources

When evidence analysis is not available, recommendations based on expert opinion must be supported by one or more credible resources and are rated as Consensus. The References supporting consensus recommendations must be from "credible resources" (e.g., position papers, standards of practice, consensus reports, articles from peer-reviewed journals, other guidelines, nationally recognized documents or websites). This evidence is not graded using the EAL Recommendation Rating Scale.

External Guidelines

Recommendations based on content from external guidelines that will be used in the development of EAL guidelines and will be graded using the Academy's Recommendation Scale, must have their development methodology reviewed by the Evidence-Based Committee (EBPC) in order to uphold the quality of the Academy's guidelines.

To be considered for inclusion into the EAL, external guidelines must meet specific methodological criteria. The external guideline methodology is assessed to ensure it meets certain criteria, adapted from the National Guidelines Clearinghouse Criteria for Inclusion of Clinical Practice Guidelines

The EBPC reviews the results from the guideline methodology assessment and uses this information for approval consideration. Those guidelines that meet criteria may be incorporated into the guidelines on the EAL and rated by the workgroup, according to the Academy's Recommendation Rating (Strong, Fair, Weak or Insufficient Evidence).

At times, the expert workgroup may also request that the EBPC consider approval of "rating equivalents," when there is no clear correlation between external guideline ratings and the EAL rating scale.

Incorporation into EAL Evidence-Based Guides for Practice

The approved external guideline or other credible resources are incorporated into the EAL Evidence-Based Guides for Practice in a similar manner to recommendations based on evidence analysis and are documented in the guideline.


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