➡️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 |