sign130

Recommendations

Info

KEY TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONS LEVELS OF EVIDENCE 1 ++ High quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 - Meta-analyses, systematic reviews, or RCTs with a high risk of bias 2 ++ High quality systematic reviews of case control or cohort studies High quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2 + Well conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal 2 - Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3 Non-analytic studies, eg case reports, case series 4 Expert opinion GRADES OF RECOMMENDATION Note: The grade of recommendation relates to the strength of the evidence on which the recommendation is based. It does not reflect the clinical importance of the recommendation. A B C D At least one meta-analysis, systematic review, or RCT rated as 1 ++ , and directly applicable to the target population; or A body of evidence consisting principally of studies rated as 1 + , directly applicable to the target population, and demonstrating overall consistency of results A body of evidence including studies rated as 2 ++ , directly applicable to the target population, and demonstrating overall consistency of results; or Extrapolated evidence from studies rated as 1 ++ or 1 + A body of evidence including studies rated as 2 + , directly applicable to the target population and demonstrating overall consistency of results; or Extrapolated evidence from studies rated as 2 ++ Evidence level 3 or 4; or Extrapolated evidence from studies rated as 2 + GOOD PRACTICE POINTS Recommended best practice based on the clinical experience of the guideline development group NHS Evidence has accredited the process used by Scottish Intercollegiate Guidelines Network to produce guidelines. Accreditation is valid for three years from 2009 and is applicable to guidance produced using the processes described in SIGN 50: a guideline developer’s handbook, 2008 edition (www.sign.ac.uk/guidelines/fulltext/50/index. html). More information on accreditation can be viewed at www.evidence.nhs.uk Healthcare Improvement Scotland (HIS) is committed to equality and diversity and assesses all its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual orientation. SIGN guidelines are produced using a standard methodology that has been equality impact assessed to ensure that these equality aims are addressed in every guideline. This methodology is set out in the current version of SIGN 50, our guideline manual, which can be found at www.sign.ac.uk/guidelines/fulltext/50/index.html. The EQIA assessment of the manual can be seen at www. sign.ac.uk/pdf/sign50eqia.pdf. The full report in paper form and/or alternative format is available on request from the Healthcare Improvement Scotland Equality and Diversity Officer. Every care is taken to ensure that this publication is correct in every detail at the time of publication. However, in the event of errors or omissions corrections will be published in the web version of this document, which is the definitive version at all times. This version can be found on our web site www.sign.ac.uk. This document is produced from elemental chlorine-free material and is sourced from sustainable forests.
Scottish Intercollegiate Guidelines Network Brain injury rehabilitation in adults A national clinical guideline March 2013
Page 1: SIGN 130 • Brain injury rehabilit
Page 5 and 6: Contents 1 Introduction ...........
Page 7 and 8: 1 Introduction 1.1 THE NEED foR A G
Page 9 and 10: 1.3.3 BRAIN INjURy SEVERITy Long te
Page 11 and 12: Functional therapies tend to be saf
Page 13 and 14: Prior to any prescribing, the licen
Page 15 and 16: 3 Assessment and treatment of mild
Page 17 and 18: False positives on cognitive testin
Page 19 and 20: 3 • Assessment and treatment of m
Page 21 and 22: 4.1.3 TASk-SPECIFIC AND REPETITIVE
Page 23 and 24: One further RCT (n=35) compared two
Page 25 and 26: 4.4 CoNTINENCE PRoBlEMS 4 • Physi
Page 27 and 28: It has been argued that there are v
Page 29 and 30: 6 Rehabilitation of behavioural and
Page 31 and 32: elationship between specific compon
Page 33 and 34: 7 Communication and swallowing 7.1
Page 35 and 36: 7.1.6 TRAINING COMMUNICATION PARTNE
Page 37 and 38: No evidence was identified relating
Page 39 and 40: 8 • Vocational rehabilitation The
Page 41 and 42: 9.1.2 MINIMALLy CONSCIOUS STATE A p
Page 43 and 44: A Cochrane review of evidence for m
Page 45 and 46: 10.2 CoMMuNITy REHABIlITATIoN 10.2.
Page 47 and 48: of improvement. There were no signi
Page 49 and 50: Evidence has also suggested the pot
Page 51 and 52: 11 Provision of information This se
Page 53 and 54:
or has mental health or addiction p
Page 55 and 56:
12 • Implementing the guideline y
Page 57 and 58:
y therapies to improve disordered s
Page 59 and 60:
Guideline development and literatur
Page 61 and 62:
Dr killian Welch Consultant Neurops
Page 63 and 64:
NMES neuromuscular electrical stimu
Page 65 and 66:
5. What is the evidence for the eff
Page 67 and 68:
15. Is there any evidence of improv
Page 69 and 70:
31. Bryant RA, Harvey AG. Relations
Page 71 and 72:
94. Goverover Y, Johnston MV, Togli
Page 73 and 74:
157. Practice parameters: assessmen
Page 75:
ISBN 978 1 905813 98 8 www.sign.ac.
show all

sign130

Create successful ePaper yourself

Delete template?

Save as template?