Background information

There were also some differences in the methodology used between the development of the VA/DoD OT  CPG and the CDC guideline. Along with a clinical evidence review, during which the evidence was evaluated using GRADE, the CDC guideline developers also considered the findings of a contextual evidence review. Further, the CDC Core Expert Group, which consisted of subject matter experts,  representatives of primary care professional societies and state agencies, and an expert in guideline methodology, reviewed recommendations drafted by the CDC and evaluated how the evidence was used in the development of the recommendations, rather than developing the recommendations themselves  (as was the VA/DoD OT Work Group’s role in the development of the VA/DoD OT CPG). While experts provided feedback on the CDC recommendations and their development, the CDC determined the final recommendations. CDC also used a review process considering and incorporating feedback from federal partners (e.g., SAMHSA, VA, DoD), stakeholders (e.g., professional organizations, delivery systems,  community organizations), and other constituents (e.g., clinicians, prospective patients). The CDC guideline development process included notice in the Federal Register for a public review and comment period as well as peer review. Thus, the recommendations made in the CDC guideline, although similar to those made in this CPG, were likely based on a slightly different evidence base and revised based on the feedback of individuals who were considering a larger group of potential patients relative to the VA/DoD. Thus, while the VA/DoD OT Work Group was aware of the release of the CDC guideline and considered potential implications, the CDC guideline did not form the basis of the deliberations on the strength or direction of these recommendations. The Work Group followed the VA/DoD Guideline for Guidelines, a document that details the process by which VA/DoD guidelines will be developed, including the use of the  GRADE methodology. As required by Congress in CARA, the Work Group reviewed and considered the  CDC guideline and its inclusion in the VA/DoD OT CPG.

Question: Mention some differences in the methodology used between the development of the VA/DoD OT CPG and the CDC guideline.
Answer: Along with a clinical evidence review, during which the evidence was evaluated using GRADE, the CDC guideline developers also considered the findings of a contextual evidence review. Further, the CDC Core Expert Group, which consisted of subject matter experts,  representatives of primary care professional societies and state agencies, and an expert in guideline methodology, reviewed recommendations drafted by the CDC and evaluated how the evidence was used in the development of the recommendations, rather than developing the recommendations themselves  (as was the VA/DoD OT Work Group’s role in the development of the VA/DoD OT CPG). While experts provided feedback on the CDC recommendations and their development, the CDC determined the final recommendations. CDC also used a review process considering and incorporating feedback from federal partners (e.g., SAMHSA, VA, DoD), stakeholders (e.g., professional organizations, delivery systems,  community organizations), and other constituents (e.g., clinicians, prospective patients).