Clinical Guidelines in Sports Medicine: Am I Reading a Guideline or a Consensus Statement: What’s the Difference? Does it Matter?
Introduction: The integration of research evidence into clinical practice is one of the most challenging aspects of sports medicine. The time required to search library databases and read multiple systematic reviews represents a significant barrier to many clinicians. Clinical guidelines and consensus statements provide a summary of best practice for clinical conditions, and provide clinical recommendations. In sports medicine, the terms clinical guideline and consensus statement are often used interchangeably; however, important differences exist between these resources. The aims of this review were to identify the clinical guidelines published in key international sports medicine journals over the last five years, and assess their methodological quality. Methods: In March 2014, the top ten international sports medicine journals (identified on current impact factors) were searched using the single keyword ‘guideline’. Peer-reviewed papers providing clinical recommendations that were described by the authors as a guideline were included. The International Centre for Allied Health Evidence (iCAHE) guideline checklist, which consists of fourteen ‘yes’ and ‘no’ responses, graded 1 or 0 respectively, was used to assess the methodological quality of each clinical guideline. Results: Ten publications were retained from a pool of 34 potentially-relevant publications. The iCAHE guideline checklist scores ranged from 3 to 11 out of a possible 14. Within the ten included publications, the most frequently identified methodological problems were a failure to describe the strategy used to search for evidence, failure to critically appraise the quality of underlying evidence and failure to clearly link the hierarchy and quality of underlying evidence to each recommendation. Discussion: The ten sports medicine journals included in this review published few clinical guidelines, and these were of poor to moderate quality. These clinical guidelines should be interpreted with caution because of methodological problems identified by this review. Consensus statements are useful resources for busy sports medicine clinicians; however, these resources should be subjected to the same rigorous appraisal as clinical guidelines, in order to identify areas where bias may potentially limit the usefulness of the recommendations.
Machotka Z, Perraton L, Grimmer K. Clinical Guidelines in Sports Medicine: Am I Reading a Guideline or a Consensus Statement: What’s the Difference? Does it Matter?. The Internet Journal of Allied Health Sciences and Practice. 2015 Jan 01;13(1), Article 11.