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