Appraisal of Evidence-Based Guidelines Assignment

Research Paper on Appraisal of Evidence-Based Guidelines Assignment

Appraisal of Evidence-Based Guidelines Assignment

Write  a fully developed and detailed APA essay addressing each of the  following points/questions. There is no required word count; be sure to  completely answer all the questions for each question in detail.  Separate each section in your paper with a clear heading that allows  your professor to know which bullet you are addressing in that section  of your paper. Sources are not required; however, if sources are used  make sure to cite using the APA writing style for the essay and complete  a reference page. The cover page is required. Review the rubric  criteria for this assignment.

Utilize  the databases identified in the text to locate an Evidence-Based  Practice Guideline, related to your topic identified in Module 1.  Perform a rapid critical appraisal of the Evidence-Based Guideline by  answering the following questions in APA format. All questions should be  answered in detail and explanations offered according to guideline  content when applicable.

• Who were the guideline developers?
• Were the developers of the guideline representative of key stakeholders in this specialty (inter-disciplinary)?
• Who funded the guideline development?
• Were any of the guideline developers funded researchers of the reviewed studies?
• Did the team have a valid development strategy?
• Was an explicit (how decisions were made), sensible, and impartial process used to identify, select, and combine evidence?
• Did  its developers carry out comprehensive, reproducible literature review  within the past 12 months of its publication/revision?
• Were all important options and outcomes considered?
• Is  each recommendation in the guideline tagged by the level/strength of  evidence upon which it is based and linked to the scientific evidence?
• Do the guidelines make explicit recommendations (reflecting value judgments about the outcomes)?
• Has the guideline been subjected to peer review and testing?
• Is the intent of use provided (i.e. national, regional, local)?
• Are the recommendations clinically relevant?
• Will the recommendations help me in caring for my patients?
• Are the recommendations practical/feasible? Are resources (people and equipment) available?
• Are the recommendations a major variation from current practice? Can the outcomes be measured through standard care?

1. The overall objective is to improve communication of clinicians towards cancer patients. Results would transmit information more clearly and without distortion from clinician to patient. Improved communication would also build trust; cement a supportive relationship, and positively effect clinical outcomes. Lastly, empathetic and effective communication will also go far in reducing patient’s distress.

2. A detailed description of the clinical question would address precisely how and in which manner would the most effective communication occur. What are the most important elements to consider when communicating with patients? Also included are questions on how to tell people that they have cancer; how to discuss the prognosis; how to prepare patients for a medical procedure; how to discuss treatment options; and how to discuss disease progression

3. The population that is covered by the guideline is cancer patients as a whole (all ages, all cancer types, both sexes, all ethnicities; no distinction is made) from the time that their disease has been discovered to all aspects of their condition and treatment.

Stakeholder Involvement

4. The guideline development group includes individuals from all the relevant professional groups

Rating 3. The generic term ‘clinician’ is used. I am not sure whether this refers to nurses, social workers, palliative care physicians, psychiatrists, psychologists, oncologists, surgeons, and family physicians as detailed in the description of the 110 participants. There are aspects of the article that make me think this term to be conducive to physician or nurse alone. I may be incorrect.

More so, it seems to me that communication with cancer patient is just as important a subject in reference to patient educators and in reference to all who come into contact with patient as consistent and abundant literature on the subject shows.

5. The patient’s views and preferences have been sought

Rating 1 & 4. It is difficult to grade this question since it is irrelevant. On the one hand, it was the cancer practitioners’ feedback that was obtained, rather than the patient’s views and preferences. On the other hand, the objective was, and is, superb communication with cancer patients so that their views and preferences can be concretely understood and fulfilled. In this way, their views and preferences have been sought.

6. The target users of the guidelines are clearly defined

Rating 2. As explained before, the generic term ‘clinician’ is used. I am not sure whether this refers to nurses, social workers, palliative care physicians, psychiatrists, psychologists, oncologists, surgeons, and family physicians as detailed in the description of the 110 participants. There are aspects of the article that make me think this term conducive to physician or nurse alone.

7. The guideline has been piloted among target users

Rating 1 The entire process on which the guideline was constructed consisted of developing and distributing evidence-based clinical guideline drafts and a survey to a relevant sample. The literature review on the subject was conducted by the Clinician-Patient Communications Working Panel of the PEBC of Cancer Care Ontario which extracted from that review several evidence-based recommendations pertinent to the issue. These were then sent to Ontario cancer practitioners for their assessment and feedback, together with a mailed survey, which asked respondents to evaluate the methods, discussion, and results of the draft. Teleconference discussion was then conducted. Never throughout was the guideline piloted on target users.

Stakeholder Involvement

4. The group that conducted the literature review and wrote out the draft was the Clinician-Patient Communications Working Panel of the PEBC of Cancer Care Ontario. The respondents were nurses, social workers, palliative care physicians, psychiatrists, psychologists, oncologists, patient educators, surgeons, and family physicians. They also included members of the Provincial Palliative Care Committee and the Provincial Psychosocial Oncology Committee.

5. The respondents were all practitioners who were closely involved with cancer patients. They were thus fully cognizant of and in touch with patients’ experiences and expectations of health care.

6. The target users are not clearly defined in the guideline, although the method used to employ their opinion indicates that the category of individuals listed may refer to the target users.

7. The guideline was based on a comprehensive literature review that was also assessed by an external body. In that way, it had been pre-tested numerous times.

Rigor of Development

8. Systematic methods were used to search for evidence

Rating 4: The literature had been thoroughly plumbed by teams of clinical, content, and methodology experts who had then drawn up and distributed a draft do their findings to Ontario cancer practitioners for review. The respondents were nurses, social workers, palliative care physicians, psychiatrists, psychologists, oncologists, patient educators, surgeons, and family physicians. They also included members of the Provincial Palliative Care Committee and the Provincial Psychosocial Oncology Committee

9. The criteria for selecting the evidence are clearly described

Rating 3: The method is clearly described. The evidence-based recommendation of the draft and examples of the EB recommendations are lacking.

10. Rating 3. The methods used for formulating recommendation are, on the whole, clearly described. There are times when the authors direct one to former research.

11. The health benefits. have been considered in formulating recommendations

Rating 1. Irrelevant question

Rigor of Development

12. There is an explicit link between the recommendation and the supporting evidence

Rating 4. Authors proceed from describing their methodology of draft and feedback to delineating the most effective methods for achieving clinician-patient communication in all stages.

13. The guidelines have been externally reviewed by experts

Rating 4. Responses were received from 33 individuals. These included nurses, social workers, palliative care physicians, psychiatrists, psychologists, oncologists, patient educators, surgeons, and family physicians, as well as members of the Provincial Palliative Care Committee and the Provincial Psychosocial Oncology Committee

14. A procedure for updating the guideline is provided.

Rating 3: Indirectly. Implications that this is so may be derived from the same methodology that prompted it in the first place and that seems to have been conducted on previous occasions. Namely, by a comprehensive review of the relevant literature and soliciting feedback from specialists.

Clarity and presentation

15. The recommendations are specific

Rating 4. Extremely so and categorized according to every conceivable situation.

16. The different options for management of the condition are clearly presented

Rating 4. Communication in the different situations is described at length and detailed, with specifics, examples, and in a clear and understandable manner.

17. Key recommendations are easily identifiable

Rating 4 The whole is clear, and recommendations in each category are italicized and accentuated.

18. The guidelines is supported with tools for application

Rating 4 Examples are liberally sprinkled throughout. Communication prescriptions are described in a way that can be understood by all.

Applicability

19. Barriers in applying guideline have been discussed

Rating 1. Not at ll. A clinician may feel discomfort in certain situations, such as in witnessing patient cry or in revealing regression of disease or condition of disease in the first place. None of these instances are mentioned.

20. The potential cost implications .. have been considered

Rating 1. Question is irrelevant.

21. The guideline presents key review criteria for monitoring

Rating 4. Criteria are thorough and specific.

22. The guideline is editorially independent from the funding body

Rating 4 The PEBC notes itself to be editorially independent from Cancer Care Ontario and the Ontario Ministry of Heath and Long-Term care.

23. Conflicts of interest of guideline members have been recorded.

Rating 4 The PEBC remarks that it is sponsored by but otherwise editorially independent from Cancer Care Ontario and the Ontario Ministry of Health and Long-Term care.

Categorize process and outcome measures using outcome evaluation methods.

ADDITIONAL INSTRUCTIONS FOR THE CLASS Research Paper on Appraisal of Evidence-Based Guidelines Assignment

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. Research Paper on Appraisal of Evidence-Based Guidelines Assignment

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. Research Paper on Appraisal of Evidence-Based Guidelines Assignment

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score. Research Paper on Appraisal of Evidence-Based Guidelines Assignment

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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