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## Glossary

The National Guideline Clearinghouse™ (NGC), sponsored by the Agency for
Healthcare Research and Quality (AHRQ), U.S. Department of Health and
Human Services, provides a glossary of clarifying definitions and
examples of terms used to describe common properties of evidence-based
clinical practice guideline abstracts (i.e., guideline summaries).

**Clinical Specialty**

> *Allergy and immunology*
>
> A medical specialty concerned with the hypersensitivity of an
> individual to foreign substances and protection from the resultant
> infection or disorder.
>
> *Anesthesiology*
>
> A medical specialty concerned with purposeful depression of nerve
> function, characterized by loss of feeling or sensation, usually the
> result of pharmacologic action by anesthetics, and induced to allow
> performance of surgery or other painful procedures. This specialty is
> also concerned with treating pain associated with diseases/conditions.
>
> *Cardiology*
>
> A medical subspecialty concerned with the study of the heart, its
> physiology, and its functions. Cardiovascular specialists are trained
> in diseases of the heart, lungs, and blood vessels and they manage
> complex cardiac conditions such as heart attacks and life-threatening,
> abnormal heartbeat rhythms.
>
> *Chiropractic*
>
> An occupational discipline based on the relationship of the spine to
> health and disease. The spine is analyzed by x-rays and palpation, and
> vertebrae are adjusted manually to relieve pressures on the spinal
> cord.
>
> *Colon and rectal surgery*
>
> A surgical specialty concerned with the diagnosis and treatment of
> various diseases of the intestinal tract, colon, rectum, anal canal,
> and perianal area by medical and surgical means. The specialty is also
> concerned with other organs and tissues (e.g., liver, urinary, and
> female reproductive system) involved with primary intestinal disease.
>
> *Critical care*
>
> A subspecialty of medicine concerned with the diagnosis, treatment,
> and support of patients with multiple organ dysfunction (i.e.,
> critically ill) during a medical emergency or crisis.
>
> *Dentistry*
>
> The profession concerned with the teeth, oral cavity, associated
> structures, and the diagnosis and treatment of their diseases
> including prevention and the restoration of defective and missing
> tissue.
>
> *Dermatology*
>
> A medical specialty concerned with the skin, its structure, functions,
> diseases, and treatment.
>
> *Emergency medicine*
>
> A medical specialty concerned with resuscitation, transportation, and
> care from the point of injury or beginning of illness through the
> hospital or other emergency treatment facility.
>
> *Endocrinology*
>
> A subspecialty of internal medicine concerned with the metabolism,
> physiology, and disorders of the internal (endocrine) system (e.g.,
> thyroid and adrenal glands). This branch of medicine also deals with
> diabetes, metabolic and nutritional disorders, pituitary diseases, and
> menstrual and sexual problems.
>
> *Family practice*
>
> A medical specialty concerned with the provision of continuing,
> comprehensive primary health care for the entire family.
>
> *Gastroenterology*
>
> A subspecialty of internal medicine concerned with the study of the
> physiology and diseases of the digestive system and related structures
> (esophagus, liver, gallbladder, and pancreas).
>
> *Geriatrics*
>
> The subspecialty of medicine concerned with the physiological and
> pathological aspects of the aged, including, but not limited to, the
> clinical problems of senescence and senility.
>
> *Hematology*
>
> A subspecialty of internal medicine concerned with morphology,
> physiology, and pathology of the blood and blood-forming tissues.
>
> *Infectious diseases*
>
> A subspecialty of medicine concerned with illnesses caused by
> microorganisms of all types in all organs.
>
> *Internal medicine*
>
> A medical specialty concerned with the diagnosis and treatment of
> diseases of the internal organ systems in adults, with the provision
> of long-term, comprehensive care in the office and the hospital
> settings, managing common and complex illnesses of adolescents,
> adults, and the elderly.
>
> *Medical genetics*
>
> A medical subspecialty concerned with the reliable prediction of
> certain genetically-linked disorders as a function of the lineage or
> genetic makeup of individuals, parents, or potential parents. The
> clinical areas include: clinical biochemical genetics, clinical
> cytogenetics, clinical genetics, clinical/medical genetics, and
> clinical molecular genetics.
>
> *Nephrology*
>
> A subspecialty of internal medicine concerned with the anatomy,
> physiology, and pathology of the kidney.
>
> *Neurological surgery*
>
> A surgical specialty concerned with the operative and non-operative
> management of disorders of the central, peripheral, and autonomic
> nervous systems, including supporting structures and vascular supply;
> the evaluation and treatment of pathological processes that modify
> function or activity of the nervous system, and the operative and
> non-operative management of pain.
>
> *Neurology*
>
> A medical specialty concerned with the study of the structures,
> functions, and diseases of the nervous system.
>
> *Nuclear medicine*
>
> A subspecialty field of radiology concerned with diagnostic,
> therapeutic, and investigative use of radioactive compounds in
> pharmaceutical form.
>
> *Nursing*
>
> The profession concerned with the provision of care and services
> essential to the promotion, maintenance, and restoration of health by
> attending to a patient\'s needs.
>
> *Nutrition*
>
> The clinical practice concerned with nutrients and other substances
> contained in food and their action, interaction, and balance in
> relation to health and disease.
>
> *Obstetrics and gynecology*
>
> The medical-surgical specialty concerned with management and care of
> women during pregnancy, parturition, and puerperium; the physiology
> and disorders primarily of the female genital tract; and female
> endocrinology and reproductive physiology. This physician may serve as
> a primary care source for women.
>
> *Oncology*
>
> A subspecialty of internal medicine concerned with the study of
> neoplasms.
>
> *Ophthalmology*
>
> A specialty concerned with the structure and function of the eye and
> the medical and surgical treatment of its defects and diseases.
>
> *Optometry*
>
> The professional practice of primary eye and vision care that includes
> the measurement of visual refractive power, and the correction of
> visual defects with lenses or glasses.
>
> *Orthopedic surgery*
>
> A surgical specialty that utilizes medical, surgical, and physical
> methods to treat and correct deformities, diseases, and injuries to
> the skeletal system, its articulations, and associated structures.
>
> *Otolaryngology*
>
> A surgical specialty concerned with the study and treatment of
> disorders of the ear, nose, throat, respiratory and upper alimentary
> systems, and related structures of the head and neck.
>
> *Pathology*
>
> A medical specialty concerned with the causes and nature of disease
> including diagnosis, prognosis, and treatment through knowledge gained
> by the laboratory application of the biological, chemical, and
> physical sciences. A pathologist uses information gathered from the
> microscopic examination of tissue specimens, cells, body fluids, and
> clinical laboratory tests on secretions.
>
> *Pediatrics*
>
> A medical specialty concerned with the physical, emotional, and social
> health of children from birth to young adulthood. Care encompasses a
> broad spectrum of health services. Neonatology is also covered under
> this specialty.
>
> *Pharmacology*
>
> A clinical specialty concerned with the effectiveness and safety of
> drugs in humans.
>
> *Physical medicine and rehabilitation*
>
> A medical specialty concerned with the use of physical agents,
> mechanical apparatuses, and manipulation in rehabilitating patients
> who are physically diseased, injured, or recovering from elective
> surgery (e.g., hip replacement) to the maximum degree possible.
> Physicians practicing this specialty are Physiatrists.
>
> *Plastic surgery*
>
> A surgical specialty that deals with the repair, reconstruction, or
> replacement of physical defects of form or function involving the
> skin, musculoskeletal system, craniomaxillofacial structures,
> extremities, breast and trunk, and external genitalia.
>
> *Podiatry*
>
> A profession concerned with the diagnosis and treatment of disorders,
> injuries and anatomic defects of the foot.
>
> *Preventive medicine*
>
> The medical specialty concerned with the health of individuals and
> defined populations to protect, promote, and maintain health and
> well-being, preventing disease, disability, and premature death.
>
> *Psychiatry*
>
> The medical specialty concerned with the origin, diagnosis,
> prevention, and treatment of mental disorders, addictive disorders,
> emotional disorders, mood disorders, anxiety disorders,
> substance-related disorders, sexual and gender identity disorders, and
> adjustment disorders.
>
> *Psychology*
>
> A clinical profession concerned with recognizing and treating behavior
> disorders.
>
> *Pulmonary medicine*
>
> A subspecialty of internal medicine concerned with the study of the
> respiratory system, especially the diagnosis and treatment of diseases
> and defects of the lungs and bronchial tree.
>
> *Radiation oncology*
>
> The specialty concerned with the therapeutic application of radiant
> energy and its modifiers, including the study and management of
> disease, especially malignant tumors.
>
> *Radiology*
>
> The specialty concerned with the use of x-ray and other forms of
> radiant energy in the diagnosis and treatment of disease.
>
> *Rheumatology*
>
> A subspecialty of internal medicine concerned with the study of
> inflammatory or degenerative processes and metabolic derangement of
> connective tissue structures that pertain to a variety of
> musculoskeletal disorders (e.g., arthritis).
>
> *Sleep medicine*
>
> The specialty concerned with conditions characterized by disturbances
> of usual sleep patterns or behaviors.
>
> *Speech-language pathology*
>
> A clinical profession concerned with the study of speech/language and
> swallowing disorders and their diagnosis and correction.
>
> *Sports medicine*
>
> A subspecialty responsible for continuous care, enhancement of health
> and fitness, and prevention of injury and illness to an individual
> engaged in physical exercise (sports).
>
> *Surgery*
>
> A medical specialty concerned with manual or operative procedures used
> in the diagnosis and treatment of diseases, injuries, or deformities.
> This specialty is usually responsible for the comprehensive management
> of the trauma victim and the critically ill surgical patient.
>
> *Thoracic surgery*
>
> A surgical specialty concerned with the operative, perioperative, and
> critical care of patients with pathologic conditions within the chest.
> Included is the surgical care of coronary artery disease, cancers of
> the lung, esophagus and chest wall, abnormalities of the trachea,
> abnormalities of the great vessels and heart valves, congenital
> anomalies, tumors of the mediastinum, and diseases of the diaphragm.
> Airway management and chest injury are within the scope of this
> specialty.
>
> *Urology*
>
> A surgical specialty concerned with the study, diagnosis, and
> treatment of diseases of the urinary tract in both sexes, and the
> genital tract in the male. This specialty also includes the management
> of benign and malignant medical and surgical disorders of the
> genitourinary system and the adrenal gland.

**Guideline Category**

> *Assessment of therapeutic effectiveness*
>
> A guideline that provides a purposeful and clear evaluation of the
> effectiveness of therapeutic modalities. Effectiveness is defined as a
> measure of the benefit resulting from an intervention for a given
> health problem under average conditions of use. This form of
> evaluation considers both the efficacy of an intervention and its
> acceptance by those to whom it is offered. It answers the question:
> Does the practice do more harm than good to people to whom it is
> offered?
>
> *Counseling*
>
> A guideline whose scope includes recommendations for interventions
> where advice or guidance is provided to patients by knowledgeable
> professionals. The advice or guidance may include education (on a
> variety of topics) or psychological support.
>
> *Diagnosis*
>
> A guideline that provides recommendations for interventions that
> determine the nature of a disease/condition or distinguish one
> disease/condition from another. Assessment may be made through
> physical examination, laboratory tests, or the like, and may be
> assisted by computerized programs designed to enhance the
> decision-making process.
>
> *Evaluation*
>
> A guideline whose scope may encompass one or both of the following
> types of clinical practices:

1.  The initial assessment that may include gathering of information
    through interview, observation, examination, and use of specific
    tests that allow patients to be evaluated for the possibility of a
    condition. Assessments may be performed by physicians, nurses and
    other health care professionals (e.g., dietitians, chiropractors,
    physical therapists, etc.).

2.  The follow-up after an intervention (e.g., evaluating treatment) and
    studies determining the effectiveness or value of processes,
    personnel, and equipment.

> *Management*
>
> A guideline whose scope integrates diagnosis, treatment, and
> monitoring or follow-up.
>
> *Prevention*
>
> A guideline that provides recommendations for the prevention of
> disease or mental disorders in susceptible individuals or populations
> through promotion of health (including mental health), and specific
> protection (e.g., immunization), as well as the prevention of
> complications or after-effects of an existing disease (i.e.,
> complications of diabetes mellitus).
>
> *Rehabilitation*
>
> A guideline that provides recommendations for interventions intended
> to promote restoration, to the maximum degree possible, of a person or
> persons suffering from disease or injury.
>
> *Risk assessment*
>
> A guideline that provides recommendations for a qualitative or
> quantitative estimation of the likelihood of adverse effects that may
> result from exposure to specified health hazards or from the absence
> of beneficial influences.
>
> *Screening*
>
> A guideline that recommends interventions be performed for the early
> detection of disease or disease precursors in apparently healthy
> individuals so that health care can be provided early in the disease
> or before the disease manifests (e.g., screening for prostate cancer).
>
> *Technology assessment*
>
> A guideline that provides an assessment/evaluation/review on the use
> of a given technology for a given application(s) and comparison to
> other technologies used to diagnose or treat the same condition.
>
> *Treatment*
>
> A guideline that recommends procedures or practices that are intended
> to relieve physical or mental illness or injury.

**Implementation Tools**

> *Audit Criteria/Indicators*
>
> Systematically developed statements that can be used to assess the
> appropriateness of specific healthcare decisions, services, and
> outcomes
>
> *Chart Documentation/Checklists/Forms*
>
> Documents, checklists, and/or forms designed to assist healthcare
> providers in administering and documenting care
>
> *Clinical Algorithm*
>
> A diagram of the guideline recommendations presented as a step-by-step
> decision-tree
>
> *Foreign Language Translations*
>
> Non-English translations of the guidelines and/or companion materials
> to facilitate the diffusion of guideline recommendations among
> non-English speakers
>
> *Patient Resources*
>
> Information for patients and/or their families or caregivers that is
> directly derived and/or prepared from the guideline; these resources
> consist of patient fact sheets, brochures, or reference guides
>
> *Personal Digital Assistant (PDA) Downloads*
>
> Interactive guideline tools intended to assist the clinician in
> implementing clinical practice guidelines at the point of care, via
> hand held devices
>
> *Pocket Guide/Reference Cards*
>
> Concise one to two page summary of the guideline recommendations
> viewed at-a-glance to provide quick reference at the point of care to
> facilitate the implementation of the guideline; may be sized to fit
> into a pocket
>
> *Quality Measures*
>
> Quality measures available in the [National Quality Measures
> Clearinghouse™ (NQMC™)](http://www.qualitymeasures.ahrq.gov/) database
>
> *Quick Reference Guides/Physician Guides*
>
> Moderate-sized documents (five or more pages) that provide a detailed
> synopsis or summary of the original guideline recommendations; these
> documents may also include algorithms illustrating various diagnostic
> and/or treatment strategies provided in the original guideline
>
> *Resources*
>
> Tools aimed at facilitating the implementation of the guideline
> recommendations which may include videos, handbooks, and other general
> provider resources
>
> *Slide Presentation*
>
> Slides that can be downloaded for use in computer slide shows,
> conventional slide presentations, or for online viewing via the Web
> that facilitate the dissemination and/or adoption of clinical practice
> guidelines
>
> *Staff Training/Competency Material*
>
> Education and/or training support materials and practical tips which
> may include educational seminars, continuing medical education
> options, satellite broadcasts, and practical tips for implementation
> of the guideline in local settings
>
> *Tool Kits*
>
> Collections of tools and/or strategies for implementing the clinical
> practice guidelines; tool kits can include worksheets/checklists,
> template letters, pocket cards, quick reference guides, assessment
> instruments, and related process and quality measures
>
> *Wall Poster*
>
> At-a-glance summary of the guideline recommendations made available in
> poster format for easy reference in a physician's office and/or other
> healthcare facility

**Institute of Medicine (IOM)**

> A private, nonprofit institution that provides objective, timely,
> authoritative information and advice concerning health and science
> policy to the government, the corporate sector, the professions, and
> the public under a congressional charter.

**Institute of Medicine (IOM) Care Needs**

> *End of life care*
>
> Care related to those not expected to survive more than six months.
>
> *Getting better*
>
> Care related to acute illness or injury.
>
> *Living with illness*
>
> Care related to chronic or recurrent illness.
>
> *Staying healthy*
>
> Care related to healthy populations or the general health needs of
> non-healthy populations (e.g., health promotion, disease prevention,
> risk factor assessment, early detection by screening and treatment of
> pre-symptomatic disease).

**Institute of Medicine (IOM) Domains**

> *Effectiveness*
>
> Relates to providing care processes and achieving outcomes as
> supported by scientific evidence.
>
> *Patient centeredness*
>
> Relates to meeting patients\' needs and preferences and providing
> education and support.
>
> *Safety*
>
> Relates to actual or potential bodily harm.
>
> *Timeliness*
>
> Relates to obtaining needed care while minimizing delays.

**Intended Users**

> *Advanced practice nurses*
>
> Professionals qualified by education at an accredited school of
> nursing and licensed by state law to practice nursing. These
> individuals have a master\'s degree or higher. This category includes
> nurse administrators, nurse anesthetists, nurse clinical specialists,
> nurse practitioners, nurse psychotherapists, and nurse midwives.
>
> *Allied health personnel*
>
> Health care workers specially trained and licensed or
> registered/certified to assist and support the work of health
> professionals. This group is designed to include most assistive
> personnel and technicians, such as behavioral therapy assistants,
> community health aides, dental assistants, dental hygienists, dental
> technicians, home health aides, medical record administrators,
> medication administration aides, nurses\' aides, psychiatric aides,
> operating room technicians, pharmacists\' aides, and radiology
> technicians. This group may also consist of health professionals who
> provide ancillary services, such as recreational therapists, music
> therapists, imaging technologists, and exercise physiologists.
>
> *Chiropractors*
>
> Individuals specially trained and licensed to practice chiropractic.
>
> *Clinical laboratory personnel*
>
> Those health care professionals, technicians, and assistants staffing
> a health care facility where specimens are collected, grown, tested or
> evaluated and the results of such are recorded (e.g., clinical
> laboratory technician/medical laboratory technician, clinical
> laboratory scientist/medical technologist, histologic
> technician/technologist, cytotechnologist, and pathologists\'
> assistant).
>
> *Dentists*
>
> Individuals licensed to practice dentistry.
>
> *Dietitians*
>
> Individuals who apply the science of nutrition to the feeding and
> education of groups of people and individuals in health and disease.
>
> *Emergency medical technicians/paramedics*
>
> Personnel trained and certified to provide basic emergency care and
> life support under the supervision of physicians and/or nurses. These
> services may be carried out at the site of the emergency, in the
> ambulance, or in a health care institution.
>
> *Health care providers*
>
> Individuals working in the provision of health services, whether as
> individual practitioners or employees of health institutions and
> programs, whether or not professionally trained, and whether or not
> subject to public regulation. Also includes those institutions or
> programs that offer health services.
>
> *Health plans*
>
> Contracts between a health insurer and a subscriber or a group of
> subscribers whereby a specified set of coverage includes medical,
> surgical, or hospital care in return for a periodic premium.
>
> *Hospitals*
>
> Includes all hospital facilities such as community hospitals, general
> hospitals, group practice hospitals, packaged hospitals, private
> hospitals, public hospitals, satellite hospitals, rural hospitals,
> special hospitals, teaching hospitals, and urban hospitals.
>
> *Managed care organizations*
>
> Organizations administering health insurance plans intended to reduce
> unnecessary health care costs through a variety of mechanisms,
> including: economic incentives for physicians and patients to select
> less costly forms of care; programs for reviewing the medical
> necessity of specific services; increased beneficiary cost sharing;
> controls on inpatient admissions and lengths of stay; the
> establishment of cost-sharing incentives for outpatient surgery;
> selective contracting with health care providers; and the intensive
> management of high-cost health care cases. The programs may be
> provided in a variety of settings, such as health maintenance
> organizations (HMO), independent practice associations (IPA), and
> preferred provider organizations (PPO), etc.
>
> *Nurses*
>
> Professionals qualified by education at an accredited school of
> nursing and licensed by state law to practice nursing. They provide
> services to patients requiring assistance in recovering or maintaining
> their physical or mental health.
>
> *Occupational therapists*
>
> Those persons legally qualified by education and training to engage in
> the practice of occupational therapy, a field concerned with the
> application of restorative, compensatory or adaptive strategies to
> promote the rehabilitation of patients.
>
> *Optometrists*
>
> Individuals licensed to practice primary eye and vision care.
>
> *Patients*
>
> Individuals participating in the health care system for the purpose of
> receiving therapeutic, diagnostic, or preventive procedures.
>
> *Pharmacists*
>
> Those persons legally qualified by education and training to engage in
> the practice of pharmacy.
>
> *Physical therapists*
>
> Those persons legally qualified by education and training to engage in
> the practice of physical therapy, a field concerned with the use of
> special techniques to prevent, correct, and alleviate movement
> dysfunction of anatomic or physiologic origin.
>
> *Physician assistants*
>
> Persons academically trained and licensed/credentialed to provide
> medical care under the supervision of a physician.
>
> *Physicians*
>
> Individuals licensed to practice medicine. This category also includes
> all physician specialists (e.g., psychiatrists).
>
> *Podiatrists*
>
> Individuals licensed to practice podiatry, the diagnosis and treatment
> of foot disorders, injuries and anatomic defects of the foot.
>
> *Psychologist/non-physician behavioral health clinicians*
>
> Persons legally qualified by education and training to practice in the
> field of mental health (e.g., psychology, counseling, and behavioral
> health).
>
> *Public health departments*
>
> International, national, state, or municipal departments concerned
> with the prevention and control of disease and disability, and the
> promotion of physical and mental health of a population.
>
> *Respiratory care practitioners*
>
> Individuals trained and certified in the field of respiratory therapy.
>
> *Social workers*
>
> Individuals trained and certified in the field of social work (e.g.,
> the use of community resources, individual case work, or group work
> that promotes the adaptive capacities of individuals in relation to
> their social and economic environments).
>
> *Speech-language pathologists*
>
> Individuals trained and certified in the field of speech-language
> pathology, a field dealing with the diagnosis and treatment of speech,
> language, and swallowing disorders.
>
> *Students*
>
> Individuals enrolled in a school or formal education program.
>
> *Substance use disorders treatment providers*
>
> Health professionals providing therapy and/or rehabilitation for
> substance-dependent individuals.
>
> *Utilization management*
>
> Individuals or groups that conduct organized procedures through
> committees to review admissions, duration of stay, professional
> services furnished, and to evaluate the medical necessity of those
> services and promote their most efficient use.

**Method of Guideline Validation**

> *Clinical validation-pilot testing/clinical validation-trial
> implementation period*
>
> These methods \"test drive\" the recommendations in an actual clinical
> setting. The information obtained during the pilot testing or initial
> implementation period is incorporated back into the guidelines in an
> attempt to improve their utility in actual practice.
>
> *Comparison with guidelines for other groups*
>
> The process whereby the guideline developer compares their
> recommendations to those issued by different groups as a way of
> gauging the validity of their guideline. The authors may explain
> conflict or agreement with guidelines for the same health problem from
> other organizations.
>
> *External peer review*
>
> The process whereby the guideline is evaluated by reviewers that do
> not belong to the same organization that developed the guideline.
>
> *Internal peer review*
>
> The process whereby the guideline is evaluated by reviewers that
> belong to the same organization that developed the guideline.
>
> *Peer review*
>
> The process to evaluate or audit the relevance, appropriateness,
> validity, or utility of the final guideline recommendations.

**Methods Used to Analyze the Evidence**

> *Decision analysis*
>
> A quantitative method for representing and comparing the expected
> outcomes of management alternatives.
>
> *Meta-analysis*
>
> A quantitative method of combining and synthesizing the results of
> multiple independent studies (usually drawn from the published
> literature) to arrive at conclusions about a body of research.
>
> *Meta-analysis of individual patient data*
>
> A meta-analysis that combines and synthesizes data collected from
> individual patient data (versus summary statistics).
>
> *Meta-analysis of observational trials*
>
> A meta-analysis that combines and synthesizes data collected from
> observational studies (e.g., a cross-sectional study, a case series, a
> case-control study, or a cohort study), versus a randomized controlled
> trial.
>
> *Meta-analysis of randomized controlled trials*
>
> A meta-analysis that combines and synthesizes data collected from
> randomized controlled trials (i.e., clinical trials that involve at
> least one test treatment and one control treatment, concurrent
> enrollment and follow-up of the test- and control-treated groups, and
> in which the treatments to be administered are selected by a random
> process, such as the use of a random-numbers table).
>
> *Meta-analysis of summarized patient data*
>
> A meta-analysis that combines and synthesizes data collected from
> summarized patient data (versus individual patient data or summary
> statistics).
>
> *Review*
>
> A summary of published material on a subject. It may be comprehensive
> to various degrees and the time range of material scrutinized may be
> broad or narrow. The conclusions of a review are often combined
> qualitatively with little, if any, quantitative manipulation of the
> published information.
>
> *Review of published meta-analyses*
>
> A summary of published meta-analyses on a subject.
>
> *Systematic review*
>
> A review of a clearly formulated question that uses systematic and
> explicit methods to identify, select and critically appraise relevant
> research and to collect and analyze data from studies that are
> included with the review.
>
> *Systematic review with evidence tables*
>
> A systematic review that utilizes a tabular compilation of the data
> from individual studies.

**Methods Used to Assess the Quality and Strength of the Evidence**

> *Expert consensus*
>
> A formal method used to generate expert collective decisions. The
> steps in the process are made explicit and could be replicated.
>
> *Expert consensus (committee)*
>
> A formal method involving a dedicated committee to generate expert
> collective decisions. The steps in the process are made explicit and
> could be replicated.
>
> *Expert consensus (Delphi method)*
>
> A formal method used to generate expert collective decisions. The
> steps in the process are made explicit and could be replicated. In the
> Delphi method, participants receive questionnaires and record their
> views. The responses are aggregated by the organizers and sent back to
> participants in summary form, indicating the group judgment and the
> individual\'s initial judgment. The participants are given the
> opportunity to revise their judgments, and the process may be
> repeated. In this method, the participants never meet face-to-face or
> interact directly.
>
> *Subjective review*
>
> A process of review relying on the use of an individual\'s or group\'s
> experience or knowledge, as conditioned by personal mental
> characteristics or states. This method uses a descriptive
> (qualitative) approach rather than a quantitative and/or numerical
> method to evaluate the quality and strength of evidence.
>
> *Weighting according to a rating scheme*
>
> This method consists of using a system that assigns a weighted value
> (e.g., levels or grades) to distinguish high from low quality research
> studies and/or strong from weak bodies of evidence. Systems have been
> developed for studies/evidence pertaining to therapy, prevention,
> diagnosis, prognosis and harm.

**Methods Used to Collect/Select the Evidence**

> *Hand searches of published literature (primary sources)*
>
> Methods based on a manual review (i.e., page-by-page) of literature
> sources that report original research (e.g., peer-reviewed journal
> articles).
>
> *Hand searches of published literature (secondary sources)*
>
> Methods based on a manual review (i.e., page-by-page) of literature
> sources that synthesize and summarize the theories and results of
> research (e.g., textbooks, monographs, review articles).
>
> *Searches of electronic databases*
>
> Methods that employ the use of free-text keywords/phrases and/or
> controlled vocabularies to identify information contained within
> computer-based repositories of information (e.g., bibliographic,
> full-text).
>
> *Searches of patient registry data*
>
> Methods that employ the use of repositories of patient-specific data
> maintained by sources such as medical specialty societies,
> disease-specific associations, government agencies, and manufacturers
> are accessed.
>
> *Searches of unpublished data*
>
> Methods that employ the use of data that has not been published (e.g.,
> proprietary data, unpublished manuscripts, data from ongoing
> research).

**Methods Used to Formulate the Recommendations**

> *Balance sheets*
>
> A tool used in clinical decision-making capturing the benefits, harms,
> and costs of different interventions. Information to complete the
> sheet is obtained from data in medical literature, local
> organizational data, or best estimates when data is of low quality or
> unknown.
>
> *Expert consensus*
>
> A parent term identifying recommendations formulated by one of several
> formal consensus development methods.
>
> *Expert consensus (Consensus development conference)*
>
> A selected group (of around ten people) is brought together to reach
> consensus about an issue in an open meeting. Evidence is presented by
> various groups/experts (who are not part of the decision-making group)
> and the selected group retreats to consider the issue and evidence.
>
> *Expert consensus (Delphi method)*
>
> Participants receive questionnaires and record their views. The
> responses are aggregated by the organizers and sent back to
> participants in summary form, indicating the group judgment and the
> individual\'s initial judgment. The participants are given the
> opportunity to revise their judgments, and the process may be
> repeated. In this method, the participants never meet face-to-face or
> interact directly.
>
> *Expert consensus (Nominal group technique)*
>
> With a purpose of structuring interaction within a group, after
> participants record views independently and privately, the facilitator
> will collect one view from each individual and create a list. All
> views are collected and listed, and discussion ensues about each view.
> Individuals then privately record their judgments or vote for options.
> Further discussion and voting may take place. The individual judgments
> are aggregated statistically to derive group judgment.
>
> *Informal expert consensus*
>
> An approach to consensus development that lacks structure.
> Participants publicly express their views, the aggregate of which may
> be summarized by the group\'s leader and considered the final
> decision.

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