CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

The highest evidence level found was selected for each intervention questions. When there
was a systematic review (SR) or meta-analysis in relation to the question, these were used as a
source of evidence and the less solid and worst quality studies were rejected. When SR or metaanalyses
could not be found, observational studies or case series were used.
The evidence level of the information obtained from other sources, such as the aforementioned
CPGs, was maintained, so long as the original source that the evidence came from was
clearly specified. In those cases where this was not clear, that information was used, but the evidence
level was lowered to a lower level, and subsequently, the degree of recommendation.
3.4. Forming guideline recommendations
Following the critical appraisal of the available evidence, the recommendations were formulated.
A discussion group was made up with the entire CPG development group, using a well-reasoned
opinion, and bearing in mind the quality of the evidence found and the clinical experience of the
CPG development group, the recommendations were gradually developed with their relative classification.
Several recommendations were prepared for each answer, indicating the level of evidence
and degree of recommendation. When the recommendations were controversial or there was no
evidence, it was solved by consensus of the development group. In those questions with respect
to which there was no clear evidence about a particular topic, the group proposed research recommendations.
3.5. Collaboration and external review
The guidelines established in the Methodology Manual for the Preparation of Clinical Practice
Guidelines in the (Spanish) National Health System 5 include the participation of expert collaborators
and external reviewers. The expert collaborators participated in the review of the questions
and the recommendations of the CPGs and the external reviewers contributed to the review of the
draft. Before sending the draft CPGs to the external reviewers, the clinical leaders of the CPG also
carried out a review of the text. The guideline development group meticulously took into consideration
all the comments and contributions made during the consultation period with the CPG
collaborators and reviewers and introduced any changes they deemed appropriate derived from
their comments. The recommendations made in this CPG do not necessarily have to coincide or
be in agreement with the contributions of the reviewers and collaborators. The final responsibility
for the recommendations lies in the CPG development group.
The informative document for people with SMI and their families, prepared by the CPG
development group, was anonymously reviewed by people who suffer from SMI and their family
members, introducing appropriate changes as a result of their comments.
The following scientific associations collaborated in the preparation of this CPG: Aragonese
Mental Health Association-Spanish Neuropsychiatry Association, National Mental Health Nursing
Association, Spanish Psychiatry Society, Aragonese Psychosocial Rehabilitation Association,
FL Crítica Versión 1.0.7 OSTEBA. Health Technologies Assessment Service Department of Health Basque Government http://
www.euskadi.net/r33-2288/es/contenidos/informacion/metodos_formacion/es_1207/metfor.html
28 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS