Evidence Review

We have developed this evidence 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


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

Evidence statements

Behind all the evidence statements in this resource lie evidence summaries. They can be found by clicking on the information icons.

We follow this strategy for grading both the quality of supporting evidence and strength of recommendations in our evidence statements:

Quality of supporting evidence

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

Strength of recommendation

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


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