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 were not applicable for this topic.
➡️Search Method
Electronic database searched:
Pubmed, Medline, Egyptian Knowledge Bank, Medscape, WebMD, Google Scholar
➡️Keywords:
Laryngectomized patients, guideline, rehabilitation, voice
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 2002 to 2023.
➡️Results:Five guidelines were selected for assessment, treatment and rehabilitation of patients having extensive Cancer larynx which necessitates total laryngectomy,1,2,3,4,5. The selected guidelines were assessed by four experts in Phoniatrics and the ASHA (2015)1. Speech-Language Pathology Medical Review Guidelines had the highest scores as regards to the currency, contents and quality. It was graded by six expert phoniatricians and reviewed by three 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
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.
WHO handbook for guideline development – 2nd ed. Chapter 10, page 129 The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to Decision frameworks (GRADE Working Group 2013) 6 |
|
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 |