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Evidence review

Translating evidence into practice

Moving Medicine evidence statements are developed according to the following process strategy for grading both the quality of supporting evidence and strength of recommendations in our evidence statements:

  • Narrative review of relevant quantitative and qualitative literature and published guidelines
  • Generation of evidence summaries and grading statments for both the quality of supporting evidence and strength of recommendation
  • Review of evidence statments by external validation group

Accumulated evidence and validated statements are then reviewed and integrated into clinician facing resources according to the following process:

  • Workshop with multi-disciplinary disease area specialists and patient representatives
  • Development of draft resource
  • Online consultation phase with healthcare professionals and patients
  • Amends to resource following feedback phase
  • External review by validation group and stakeholders
  • Publication to live site

How we write our evidence statements

Grading definitions for quality of supporting evidence statements

Grade A – High quality

  • Evidence from randomised controlled trials is consistent and of high quality
  • Evidence of a different nature (eg large epidemiological data sets) is compelling and consistent
  • This conclusion is not expected to change with future research

Grade B – Moderate quality

  • Evidence from randomised controlled trials has limitations such as inconsistency of findings and concerns about quality eg risk of bias
  • Strong evidence from a different research design
  • Future research may change this conclusion

Grade C – Low Quality
  • Evidence from poorly undertaken controlled trials with major flaws
  • Evidence from observational studies or unsystematic clinical experience including expert opinion
  • All estimates of effect size are uncertain

Grading definitions for strength of recommendation statements

Grade 1 – Strong recommendation
  • On the basis of the existing evidence, clinical opinion is that all or most patients will be best served by following this piece of evidence
  • The vast majority of patients would choose to follow this evidence when given the choice
Grade 2 – Weak recommendation
  • On the basis of the existing evidence, some patients will be best served by following this piece of evidence
  • In the context of values-based decision making, fully informed patients may choose alternative options

Developing the prescribing movement resources

The prescribing movement resource framework was developed according to an established knowledge into action framework [1]. This has two main components:

1. Knowledge creation

This process involves tailoring the knowledge around a subject to meet the project objectives. The following process has been undertaken by subject leads in each disease area:

  • Narrative review of reviews, qualitative literature and guidelines regarding the role of physical activity in the treatment and of each disease area
  • Scrutiny of summary evidence by external validation group
  • Workshop with multi-disciplinary disease area specialists and patient representatives
  • Development of draft resource
  • Online consultation phase with healthcare professionals and patients
  • Amends to resource following feedback phase
  • External review by validation group and stakeholders

2. Action cycle

The action cycle has driven the development of the layout and delivery mechanism behind these resources. The aim of this component of the knowledge into action cycle is to address the barriers to access and usage of the information generated by the knowledge creation phase in the context of usage in clinical practise. Prior to launch and further evaluation and refinement once online, the key components of this phase have been:

  • Review of behavioural change theory and guidelines applied to clinical practise including brief interventions
  • Two workshops with multidisciplinary team and expert patients to determine key components of information delivery model and clinical priorities
  • Development of a COM-B behavioural change framework to identify and map key behavioural change techniques, intervention functions and policy categories for implementation and design of the resource
  • Three stage Delphi consensus process to develop and refine the resource

References

Petzold A, Korner-Bitensky N, Menon A. Using the Knowledge to Action Process Model to Incite Clinical Change. doi:10.1002/chp.20077

Updates

Information in this website will be updated in a three year update cycle.