The type and evaluation of evidence in clinical pathways

Article type
Authors
Gu W1, Wei D1, Yao L1, Yuan T1, Wei L1, Ma W1, Shang W1, Li Y1, Xun Y1, Shi X2, Yang K1
1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhouï¼› Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou
2Gansu Rehabilitation Center Hospital, Lanzhou, 730000,China
Abstract
Background: Clinical pathways are important bridges for connecting guideline and clinical practice. They should be developed based on evidence-based clinical practice guidelines, systematic reviews, etc.The clinical pathway manual outlines the norms and standards to develop a clinical pathway for researchers.It should be stated in the manual how to collect and evaluate the evidence in clinical pathway.

Objectives:To investigate and analyse the methods and procedures on the type and evaluation of evidence in clinical pathways manuals.

Methods:We searched the manuals of clinical pathways in PubMed and Google and filtered the documents that meet the criteria. Using a standardised form to extract and analyse the manuals’information on type and evaluation of evidence in clinical pathways manual.

Results:A total of 22 manuals met the inclusion criteria, which were published between 1993 and 2017. 6(27.3%) reported the sources of evidence, which were the existing clinical pathway, guideline, systematic review and a randomised-controlled trial, etc. 3(13.6%) reported the evaluation of evidence, of which 2(9.1%) reported the specific evidence classification methods, which were respectively SIGN classification method and a method researched independently. Recommended intensity classification of diagnosis and treatment schemes in 22 manuals was not reported (Table 1).

Conclusions: Manuals states that evidence of clinical pathway should be from the existing clinical pathway,guideline,systematic review and a randomised-controlled trial,etc.The collection,quality evaluation and recommended intensity classification method of evidence were reported unclearly.