Evidence-based Clinical Practice Guidelines Research Articles

Interventional Strategies for Children with Progressive Pulmonary Hypertension Despite Optimal Therapy. An Official American Thoracic Society Clinical Practice Guideline.

Pulmonary hypertension in children often progresses despite optimal therapy. This document provides an evidence-based clinical practice guideline for the management of children with progressive pulmonary hypertension despite optimal therapy. A multidisciplinary panel identified pertinent questions regarding the management of children with pulmonary hypertension that has progressed despite optimal therapy, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop clinical recommendations. After reviewing the research evidence, the panel considered the balance of desirable (benefits) and undesirable (harms and burdens) effects of the interventions in each proposed question. Valuation of our main outcomes was also considered, along with resources required, equity, acceptability, and feasibility. Recommendations were developed for or against interventional strategies specific to children with pulmonary hypertension that has progressed despite optimal therapy. Although there is a growing population of children with pulmonary hypertension, there is a striking lack of empirical evidence regarding management of those whose disease has progressed despite optimal pharmacotherapy. The panel formulated and provided the rationale for clinical recommendations for or against interventional strategies based on this limited empirical evidence, coupled with expert opinion, to aid clinicians in the management of these complex pediatric patients. In addition, we identified important areas for future research.

Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision – 2024

The Academy of Orthopaedic Physical Therapy (AOPT) has an ongoing effort to create evidence-based clinical practice guidelines (CPG) for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The 2024 Achilles Pain, Stiffness, and Muscle Power Deficit: Midportion Achilles Tendinopathy Clinical Practice Guideline (CPG) is a revision of the 2018 CPG and represents the third CPG from AOPT on this topic. The goals of the revision were to provide a concise summary of the contemporary evidence and to develop new recommendations or revise previously published recommendations to support evidence-based practice. This current CPG covers prevalence, pathoanatomical features, risk factors, clinical course, diagnosis, examination, imaging and physical therapy interventions for the management of midportion Achilles tendinopathy.

Discrepancies in ChatGPT's Hip Fracture Recommendations in Older Adults for 2021 AAOS Evidence-Based Guidelines.

Background: This study aimed to assess the reproducibility and reliability of Chat-Based GPT (ChatGPT)'s responses to 19 statements regarding the management of hip fractures in older adults as adopted by the American Academy of Orthopaedic Surgeons' (AAOS) evidence-based clinical practice guidelines. Methods: Nineteen statements were obtained from the 2021 AAOS evidence-based clinical practice guidelines. After generating questions based on these 19 statements, we set a prompt for both the GPT-4o and GPT-4 models. We repeated this process three times at 24 h intervals for both models, producing outputs A, B, and C. ChatGPT's performance, the intra-ChatGPT reliability, and the accuracy rates were assessed to evaluate the reproducibility and reliability of the hip fracture-related guidelines. Regarding the strengths of the recommendation compared with the 2021 AAOS guidelines, we observed accuracy of 0.684, 0.579, and 0.632 for outputs A, B, and C, respectively. Results: The precision was 0.740, 0.737, and 0.718 in outputs A, B, and C, respectively. For the reliability of the strengths of the recommendation, the Fleiss kappa was 0.409, indicating a moderate level of agreement. No statistical differences in the strengths of the recommendation were observed in outputs A, B, and C between the GPT-4o and GPT-4 versions. Conclusion: ChatGPT may be useful in providing guidelines for hip fractures but performs poorly in terms of accuracy and precision. However, hallucinations remain an unresolved limitation associated with using ChatGPT to search for hip fracture guidelines. The effective utilization of ChatGPT as a patient education tool for the management of hip fractures should be addressed in the future.

Treatment of Macrolide-resistant Mycoplasma pneumoniae Pneumonia in Children: A Meta-analysis of Macrolides Versus Tetracyclines.

The global prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia infections, particularly in children, is on the rise. It is imperative to assess the clinical efficacies of alternative antibiotics such as tetracyclines to ensure effective treatment, mitigate antibiotic resistance, enhance clinical outcomes, and minimize the spread of resistant strains among MRMP-infected children. The objective of this study was to compare the therapeutic efficacies of macrolides and tetracyclines in treating MRMP pneumonia in children. We systematically searched the literature to identify comparative studies that examined the clinical outcomes of macrolide and tetracycline antibiotics in children with MRMP pneumonia. We conducted a meta-analysis of the mean duration of fever, hospital stay duration, therapeutic efficacies, and time to defervescence to compare macrolides and tetracyclines. Eleven studies involving 1143 patients compared the clinical efficacies of macrolides and tetracyclines in children with MRMP pneumonia. The studies were conducted in China, Japan, and Korea, and the outcomes of febrile days, hospital stay duration, therapeutic efficacy, and time to defervescence were analyzed. The macrolides studied were azithromycin and clarithromycin, whereas the tetracyclines included minocycline and doxycycline. The pooled estimate of 5 studies showed that the mean duration of febrile days and hospital stay was longer in the macrolides group than tetracycline group [weighted mean difference = 1.64 days, 95% confidence interval (CI): 0.68-2.59, weighted mean difference = 1.22 days, 95% CI: 0.82-1.62, respectively]. The therapeutic efficacy was significantly lower in the macrolide group than in the tetracycline group (odds ratio: 0.33, 95% CI: 0.20-0.57). The clinical efficacy of tetracycline treatment was superior to that of macrolide treatment in children with MRMP pneumonia. However, further research is required to validate these findings and inform evidence-based clinical practice guidelines.

Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association Academy of Pediatric Physical Therapy.

Congenital muscular torticollis (CMT) is a postural condition evident shortly after birth. The 2013 CMT Clinical Practice Guideline (2013 CMT CPG) set standards for the identification, referral, and physical therapy management of infants with CMT, and its implementation resulted in improved clinical outcomes. It was updated in 2018 to reflect current evidence and 7 resources were developed to support implementation. Purpose: This 2024 CMT CPG is intended as a reference document to guide physical therapists, families, health care professionals, educators, and researchers to improve clinical outcomes and health services for children with CMT, as well as to inform the need for continued research. Results/Conclusions: The 2024 CMT CPG addresses: education for prevention, screening, examination and evaluation including recommended outcome measures, consultation with and referral to other health care providers, classification and prognosis, first-choice and evidence-informed supplemental interventions, discontinuation from direct intervention, reassessment and discharge, implementation and compliance recommendations, and research recommendations.

Defects in Value Associated With Hospital-Acquired Conditions: How Improving Quality Could Save U.S. Healthcare $50 Billion.

Hospital-acquired conditions in the United States are considered avoidable complications but remain common statistics reflecting on health system performance and are a leading cause of patient fatality. Currently, over 3.7 million patients experience a hospital-acquired condition in the United States each year, which costs the U.S. healthcare delivery system an excess of $48 billion. Evidence-based clinical practice guidelines for common hospital-acquired conditions (e.g., infections, falls, pressure injuries) to reduce risk to the patient. In each of these instances, preventing the outcome with these guidelines costs less than treating the outcome, in addition to keeping the patient safe from harm. By applying the framework of defects in value to hospital-acquired conditions, we estimate that U.S. health systems could avert this $48 billion in spending on treating harmful hospital-acquired conditions; more so, these systems of care could recuperate over $35 billion after investing proportionally in a system that delivers greater quality by preventing hospital-acquired conditions over treating them. Currently, the Centers for Medicare and Medicaid Services only withholds reimbursements for hospital-acquired conditions and penalizes health systems with high rates of these outcomes. However, payers do not offer any reward-based incentives for hospital-acquired condition prevention. A series of policy and health system solutions, including tracking of hospital-acquired condition rates in electronic health records, identifying centers of excellence at reducing rates of harm with the use of clinical practice guidelines, and rewarding them monetarily for reduced rates could create equal-sided risk and opportunity to engage health systems in improved performance.

2023 American Academy of Orthopaedic Surgeons Management of Osteoarthritis of the Hip Evidence-Based Clinical Practice Guideline: Case Studies.

The American Academy of Orthopaedic Surgeons, together with The Hip Society, American Association of Hip and Knee Surgeons, American College of Radiology, and American Physical Therapy Association, recently released the updated 2023 Management of Osteoarthritis of the Hip Evidence-Based Clinical Practice Guidelines. 8 recommendations and 9 options comprise these guidelines intended to optimize treatment outcomes in a patient population that is growing exponentially over time. In this article, we present case studies that illustrate utilization of the clinical practice guideline workgroup's evidence-based recommendations in clinical practice.

Direct Composite Restorations on Permanent Teeth in the Anterior and Posterior Region - An Evidence-Based Clinical Practice Guideline - Part 2: Recommendations for Composite Processing.

Part 2 of this German S3 clinical practice guideline provides recommendations for the process of manufacturing composite restorations. It covers key aspects like caries removal, field isolation, matrix and adhesive techniques, as well as light curing and polishing. The outcomes of interest include survival rates and restoration quality. A systematic literature search was conducted by two methodologists using MEDLINE and the Cochrane Library via the OVID platform, including studies up to December 2021. Additionally, the reference lists of relevant manuscripts were manually reviewed. Six PICO questions were developed to guide the search. Consensus-based recommendations were for- mulated by a panel of dental professionals from 20 national societies and organizations based on the collected evidence and ex- pert opinion. The guideline advocates for one-stage selective caries removal near the pulp and underscores the effectiveness of various isolation techniques, adhesive systems, and the crucial role of light polymerization. The use of anatomically pre- formed sectional matrices and phosphoric acid etching is recommended to enhance restoration quality. Additionally, polish- ing composite restorations is advised to improve surface finish. This guideline provides comprehensive recommendations that inform clinicians on optimizing the composite restor- ation manufacturing processes. The adoption of these best practices can improve the quality and longevity of dental restorations.

Direct Composite Restorations on Permanent Teeth in the Anterior and Posterior Region - An Evidence-Based Clinical Practice Guideline - Part 1: Indications for Composite Restorations.

This German S3 clinical practice guideline offers evidence-based recommendations for the use of composite materials in direct restorations of permanent teeth. Outcomes considered were the survival rates and restoration quality and process quality of the manufacturing process. Part 1 of this two-part presentation deals with the indication classes. A systematic literature search was conducted by two methodologists using MEDLINE and the Cochrane Library via the OVID platform, including studies up to December 2021. Six PICO questions were developed to guide the search. Recommendations were formulated by a panel of dental professionals from 20 national societies and organizations based on the collected evidence. Composite materials are a viable option for the direct restoration of cavity Classes I-V and may also be used for restorations with cusp replacement, and tooth shape corrections. In the posterior region, direct composite restorations should be preferred over indirect composite inlays. For Class V restorations, composite materials can be used if adequate contamination control and adhesive technique are ensured. The guideline is the first to provide comprehensive evidence on the use of direct composite materials. However, further long-term clinical studies with comparators such as (modified) glass-ionomer cements are necessary. Regular updates will detail the future scope and limitations of direct composite restorations.

Pathway to Excellence: One Institution's Experience Obtaining the Joint Commission's Advanced Total Hip and Total Knee Replacement Certification.

As the prevalence of total hip and total knee arthroplasty procedures increase over the next decades, hospitals seek opportunities to improve quality outcomes while simultaneously limiting costs and mitigating risks of complications. The Joint Commission's Advanced Total Hip and Total Knee Replacement (THKR) certification is one of the highest quality standard certification programs in the nation and is the only one that collaborates with the American Academy of Orthopedic Surgeons. To obtain THKR certification, several requirements based on evidence-based clinical practice guidelines must be met. The process is described from initial identification of stakeholders to ongoing efforts to retain certification. Joint Commission THKR certification was awarded after rigorous review and on-site visit. Compliance with advanced care standards from the time of orthopedic consultation through postsurgical follow-up was reviewed. Joint Commission THKR certification provides supporting evidence of the institutions journey in processes toward delivering high quality clinical care. A multidisciplinary team with ongoing collaboration is necessary to obtain and retain certification.

Introducing NASN's School Nursing Evidence-Based Clinical Practice Guideline: Allergy and Anaphylaxis CPG and Implementation Toolkit.

Clinical Practice Guidelines (CPGs) are statements informed by a systematic review of research/evidence and provide recommendations for clinical practice to improve healthcare quality and patient outcomes. The National Association of School Nurses (NASN) released School Nursing Evidence-Based Clinical Practice Guideline: Students with Allergies and Risk for Anaphylaxis, in 2023, to provide evidence-based recommendations specific to school nursing practice and support the role of the school nurse in providing high-quality care for school-age children with allergies and risk for anaphylaxis. This article will provide an overview of the CPG and Implementation Toolkit. The implementation toolkit is designed to provide school nurses with tools and resources to implement the recommendations into practice. These tools and resources include school policies; nursing assessments and intake; planning, training, implementing, and evaluating care; and data collection. Examples are discussed, including how to customize the toolkit resources to your current practice needs.

Currently Available Large Language Models Do Not Provide Musculoskeletal Treatment Recommendations That Are Concordant With Evidence-Based Clinical Practice Guidelines

PurposeTo determine whether leading, commercially-available LLMs provide treatment recommendations concordant with evidenced-based clinical practice guidelines (CPGs) developed by the American Academy of Orthopedic Surgeons (AAOS). MethodsAll CPGs concerning the management of rotator cuff tears(n=33) and anterior cruciate ligament (ACL) injuries(n=15) were extracted from the AAOS. Treatment recommendations from Chat-generative pretrained transformer version-4 [ChatGPT-4; OpenAI], Gemini (Google), Mistral-7B (Mistral AI), and Claude-3 (Anthropic) were graded by two blinded physicians as being “concordant,” “discordant,” or “indeterminate” (i.e., neutral response without definitive recommendation) with respect to AAOS CPGs. The overall concordance between LLM and AAOS recommendations were quantified, while the comparative overall concordance of recommendations amongst the four LLMs was evaluated through the Fischer’s-exact test. ResultsOverall 135(70.3%) responses were concordant, 43(22.4%) indeterminate, and 14(7.3%) discordant. Inter-rater reliability for concordance classification was excellent (Kappa=0.92). Concordance with AAOS CPGs was most frequently observed with ChatGPT-4 (n=38, 79.2%), and least frequently with Mistral-7B (n=28,58.3%). Indeterminate recommendations were most frequently observed with Mistral-7B (n=17,35.4%) and least frequently with Claude-3 (n=8, 6.7%). Discordant recommendations were most frequently observed with Gemini (n=6,12.5%) and least frequently with ChatGPT-4 (n=1,2.1%). Overall, no statistically significant differences in concordant recommendations was observed across LLMs (p=0.12). Only 20 (10.4%) of all recommendations were transparent and provided references with full bibliographic details or links to specific peer-reviewed content to support recommendations. ConclusionAmong leading commercially-available LLMs, more than one-in-four recommendations concerning the evaluation and management of rotator cuff and ACL injuries do not reflect current evidenced-based CPGs. Although ChatGPT-4 demonstrated the highest performance, clinically significant rates of recommendations without concordance or supporting evidence were observed. Only 10% of responses by LLMs were transparent, precluding users from fully interpreting the sources from which recommendations were provided. Clinical RelevanceWhile leading LLMs generally provide recommendations concordant with CPGs, a substantial error-rate exists, and the proportion of recommendations that do not align with these CPGs suggest that LLMs are not trustworthy clinical support tools at this time. Each off-the-shelf, closed-source LLM has strengths and weaknesses. Future research should evaluate and compare multiple LLMs to avoid bias associated with narrow evaluation of few models as observed in current literature.

First-line managers’ experience of guideline implementation in orthopaedic nursing and rehabilitation: a qualitative study

BackgroundFirst-line managers have a unique role and potential in encouraging the use of evidence-based clinical practice guidelines (CPGs) and thus serve the provision of safe patient care. In acute and planned hospital care, effective yet safeguarded nursing procedures are a necessity. Little is currently known about how first-line managers engage in supporting the adoption of evidence-based nursing care and about what barriers and enablers there are for implementation of CPGs in the orthopaedic care context.PurposeTo investigate first-line managers’ experience of clinical practice guideline implementation in orthopaedic care.MethodsThis qualitative interview study included 30 first-line nursing and rehabilitation managers in 17 orthopaedic units in Sweden. A deductive content analysis, with the Ottawa Model of Implementation Leadership as a guide, was employed.ResultsTo the first-line managers, any guideline implementation required them to balance contexts, including their outer context (signified by the upper-level management and decision-makers) and their inner context, including staff and patients in their unit(s). Acting in response to these contexts, the managers described navigating the organization and its terms and conditions; using relations-, change-, and task-oriented leadership, such as involving the staff; motivating the change by emphasizing the patient benefits; and procuring resources, such as time and training. Even though they knew from past experience what worked when implementing CPGs, the first-line managers often encountered barriers within the contexts that hampered successful implementation.ConclusionsAlthough first-line managers know how to effectively implement CPGs, an organization’s terms and conditions can limit their opportunities to fully do so. Organizational awareness of what supports and hinders first-line managers to offer implementation leadership can enhance opportunities to alter behaviours and conditions for the benefit of CPG implementation.Trial registrationThe study was registered as NCT04700969 with the U.S. National Institutes of Health Clinical Trials Registry on 8 January 2021.

Guideline recommendations on the role of the general practitioner in the diagnosis of dementia: a protocol for a scoping review of clinical practice guidelines

Introduction A timely diagnosis of dementia offers the opportunity of earlier intervention and activation of coordinated care plans. General Practitioners (GPs) play a key role in dementia diagnosis, from symptom recognition to clinical assessment, investigation, diagnosis and onward referral for confirmation of the diagnosis and subtyping. Dementia clinical practice guidelines (CPGs) offer clinicians guidance on dementia care but often do not specifically address the role of the GP in the diagnostic process. This protocol outlines a scoping review to identify evidence-based dementia clinical practice guidelines and map the recommended role of GPs in the diagnosis of dementia. Method The scoping review will be conducted using the Arksey and O'Malley framework, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) will be used to guide the reporting. We will search five electronic databases (PubMed, CINAHL, Embase, PsycINFO, Cochrane Library) for dementia CPGs published since 2019. CPGs are often not published in peer-reviewed journals; therefore, a parallel search of relevant grey literature will be conducted. We will also search the websites of GP professional organisations and guideline developers. Two reviewers will independently screen all articles based on inclusion criteria, with conflicts resolved by a third reviewer. Conclusion This scoping review will examine up-to-date dementia CPGs to determine recommendations for the role of GPs in the assessment, investigation, diagnosis and onward referral of patients with suspected dementia to secondary care.

Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines.

Existing studies have highlighted suboptimal diabetes management in residential aged care facilities (RACFs). However, understanding of diabetes management in Australian metropolitan RACFs has been limited. This retrospective cohort study aimed to explore the pharmacological management of diabetes in 25 RACFs in Sydney Australia and assess concordance with clinical practice guidelines (CPGs). Data from 231 permanent RACF residents aged ≥65 years and over with type 2 diabetes mellitus over the period from 1 July 2016 to 31 December 2019 were used. Concordance was measured by assessing the medications and medical history data for each individual resident for concordance with evidence-based CPGs. Multivariable logistic regression was used to estimate the effect of resident characteristics on concordance with CPGs. Of the 231 residents with diabetes, 87 (38%) were not taking any antidiabetic medication. Pharmacological management inconsistent with CPG recommendations was observed for 73 (32%) residents, with the most common reason for non-concordance being the use of medications with significant adverse effects in older adults (47, 2%). Residents with hypertension or other heart diseases in addition to their diabetes had greater odds of their diabetes management being non-concordant with CPGs (OR = 2.84 95% CI = 1.54, 5.3 and OR = 2.64, 95% CI = 1.07, 6.41, respectively). Pharmacological diabetes management in metropolitan Australian RACFs is suboptimal, with a high prevalence of inconsistency with CPGs (32%) observed. Additionally, having hypertension or heart diseases significantly increased the possibility of non-concordance among diabetic RACF residents. Further investigation into the underlying relationships with comorbidities is required to develop better strategies.

Ventilator strategies in congenital diaphragmatic hernia

This review focuses on contemporary mechanical ventilator practices used in the initial management of neonates born with congenital diaphragmatic hernia (CDH). Both conventional and non-conventional ventilation modes in CDH are reviewed. Special emphasis is placed on the rationale for gentle ventilation and the current evidence-based clinical practice guidelines that are recommended for supporting these fragile infants. The interplay between CDH lung hypoplasia and other key cardiopulmonary elements of the disease, namely a reduced pulmonary vascular bed, abnormal pulmonary vascular remodeling, and left ventricular hypoplasia, are discussed. Finally, we provide insights into future avenues for mechanical ventilator research in CDH.

Recommendations for Screening and Monitoring the Stages of Type 1 Diabetes in the Immune Therapy Era.

Type 1 diabetes (T1D) is a complex, chronic autoimmune disease that affects over 1.6 million people in the United States. It is now understood that T1D may be undetected for many years while the disease progresses quietly without producing symptoms. T1D can be identified through diabetes-related autoantibody screening and staged accordingly, enabling healthcare providers to identify high-risk individuals in the early stages of the disease and either provide a stage-specific intervention or offer clinical trial opportunities to preserve beta cell function and anticipate the onset of clinical T1D. Evidence-based clinical practice guidelines currently do not exist for routine diabetes-related autoantibody screening of individuals at risk of developing T1D or of the general population. The purpose of this article is to help clinicians acquire an understanding of the rationale and protocols recommended for identifying patients at risk of developing T1D and monitoring such patients for autoimmune markers and progression of disease from Stage 1 to Stage 3 (clinical disease).

Tamsulosin off-label use in kidney stones: Review and survey

This study investigates the effectiveness and healthcare perceptions of Tamsulosin, an off-label medication for kidney stone management. Despite the documented benefits, the quest for alternative treatments like Tamsulosin persists, driven by its advantages and patient satisfaction levels. This research includes a literature review and a survey of pharmacy students’ opinions on Tamsulosin, aiming to bridge the knowledge gap. This study, which involved 38 first-year professional pharmacy students, achieved a 92% response rate. The research used questionnaire that collected demographic information and assessed participants' knowledge and opinions using a Likert scale, which was integrated into a drug informatics course. We analyzed the responses using SPSS software, utilizing descriptive and chi-square statistical methods. The survey, completed by 38 participants, revealed discrepancies between current treatment practices and the students' understandings. Despite Tamsulosin's documented efficacy in facilitating stone passage, significant skepticism exists about its use without FDA approval. The research showed varied levels of understanding and skepticism towards off-label use among the students. Moreover, 70.3% of respondents recognized Tamsulosin's potential for managing kidney stones, despite its lack of FDA approval, indicating a cautious yet acknowledging attitude towards non-approved drug use for organ rejection. There's a noted need for improved education and the dissemination of evidence-based guidelines in clinical practice. The study uncovers varied knowledge and perceptions among healthcare professionals and pharmacy students regarding Tamsulosin's use in kidney stone management. The gap between clinical evidence and survey participants' awareness underscores the importance of further research and education to align clinical practices with evidence-based guidelines

Dyspnea and Palliative Care in Advanced Chronic Obstructive Pulmonary Disease: A Rapid Review.

Dyspnea is the most common and activity-limiting symptom for those with chronic obstructive pulmonary disease (COPD). Treatment is complex, palliative care (PC) dyspnea relief interventions are poorly understood, and PC remains underutilized in COPD despite national guidelines and recommendations. The purpose of this rapid review was to explore the concept of dyspnea and role of PC through the lens of providers, caregivers, and patients with COPD. A systematic approach for synthesis was used to identify 13 articles published between January 2018 and October 2023. Team members compared data via visualization and theme clustering to identify key conclusions describing operationalization of dyspnea, management, and PC implications. Dyspnea operationalization was challenging, with inconsistent measurement and terminology. Dyspnea was a significant burden in COPD and contributed to complexity of treatment. Opioids were used most often to treat dyspnea, but provider perspectives and biases can influence treatment decisions and perceptions of opioid therapy by the patient and caregiver. Evidence-based clinical practice guidelines and policies are needed to clarify the use of opioid therapy for dyspnea management to reduce stigmatization and barriers to treatment. Provider education should emphasize a multipronged approach to treatment of dyspnea in COPD with integration of PC early in the care continuum.

American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary Management of Osteoarthritis of the Hip.

The Management of Osteoarthritis (OA) of the Hip Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies examining the treatment of OA of the hip in adults (aged 18 years and older). Based on the best current available evidence, this guideline contains eight recommendations and nine options to assist orthopaedic surgeons and all qualified physicians managing patients who have been diagnosed by a trained healthcare provider with OA of the hip and are currently undergoing treatment. It is also intended to serve as an information resource for professional healthcare practitioners and developers of practice guidelines and recommendations. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in the literature and informs areas for future research and quality measure development.