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PHONIATRICS Brain damage motor handicap BDMH CORRECTED

- Methods

➡️Methods of development

Stakeholder Involvement: Individuals who were involved in the development process. Included the above-mentioned phoniatrics Chief Manager, phoniatrics Executive Manager, Assembly Board, Grading Board and Reviewing Board.

Information about target population experiences was not applicable for this topic.

➡️Search Method

Electronic database searched:Pubmed, Google Scholar, Egyptian Knowledge Bank, Medscape.

➡️Keywords

Cerebral palsy, Brain damage, Guideline, Children

The adaptation cycle passed over: set-up phase, adaptation phase (Search and screen, assessment: currency, content, quality&/decision/selection) and finalization phase that included revision and external reviewing.

➡️Time period searched: from 2010 till 2021

➡️Results

Four national phoniatricians reviewed the guidelines available

Cerebral palsy in under 25s: assessment and management (NICE, 2017)2 gained the highest scores as regards currency, content and quality and were thus adopted then adapted

-  It was graded by 9 expert reviewers' experts and reviewed by 6 expert reviewers to improve quality, gather feedback on draft recommendations.

The external review was done through a rating scale as well as open-ended questions.

➡️Setting: Primary, secondary and tertiary care centers & hospitals, and related specialties.

Interpretation of strong and conditional recommendations for an intervention (World Health Organization, 2014)

Audience

Strong recommendation

Conditional recommendation

Patients

Most individuals in this situation would want the recommended course of action; only a small proportion would not.

Formal decision aides are not likely to be needed to help individuals make decisions consistent with their values and preferences.

Most individuals in this situation would want the suggested course of action, but many would not

Clinicians

Most individuals should receive the intervention.

Adherence to the recommendation could be used as a quality criterion or performance indicator.

Different choices will be appropriate for individual patients, who will require assistance in arriving at a management decision consistent with his or her values and preferences. Decision aides may be useful in helping individuals make decisions consistent with their values and preferences.

Policymakers

The recommendation can be adopted as policy in most situations.

Policy-making will require substantial debate and involvement of various stakeholders.


The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to Decision frameworks (GRADE Working Group, 2013)

Grade

Definition

High

 

We are very confident that the true effect lies close to that of the estimate of the effect.

Moderate

 

We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different

Low

 

Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.

Very Low

 

We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect