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Quality & Practice

Guideline Endorsement Policy

AAPM&R acknowledges that many organizations are producing quality guidelines that would benefit the membership of AAPM&R. AAPM&R is committed to systematically evaluating these documents and disseminating appropriate documents to its membership. This scheme seeks to provide tiered levels of AAPM&R endorsement of these products. The primary criteria AAPM&R uses to assess guidelines submitted for endorsement is the quality of the process used to develop the document. This includes an assessment of the use of evidence vs. consensus and the appropriate linkage of evidence to recommendations.  

Documents that fulfill the criteria listed below are eligible for AAPM&R endorsement. Documents that do not fulfill all of the criteria may be eligible for the second tier of endorsement—Affirmation of Value.  Eligibility for endorsement does not guarantee endorsement, and endorsement does not guarantee publication in PM&R - The journal of injury, function and rehabilitation.

AAPM&R’s standards for endorsement of a clinical practice guideline are:

  • Recommendations based on peer reviewed evidence

  • Comprehensive, systematic review of the literature

  • Classification of evidence based on quality of study design

  • Recommendations linked directly to the evidence

  • Recommendations weighted based on the strength of supporting evidence 

Many practice guidelines use a combination of peer reviewed evidence and expert consensus to make practice recommendations. The AAPM&R process stresses the evidence component in the development of guidelines. In AAPM&R guidelines, recommendations cannot be based on consensus alone; the presentation of consensus evidence is restricted to the body of the document. Documents that are based in expert consensus are not eligible for AAPM&R endorsement as a practice guideline. AAPM&R will consider consensus-based documents for the second tier of AAPM&R endorsement—Affirmation of Value. 

AAPM&R encourages other organizations to inform AAPM&R of their intent to request endorsement as early in the process of developing the guideline as possible. Although AAPM&R endorsement does not require AAPM&R input into the guideline, the likelihood of endorsement is greatly increased by AAPM&R’s involvement in, and knowledge of, the development of the guideline. 

Upon receipt of a request for endorsement, AAPM&R will undertake a screening review of the guideline for interest and priority. The Practice Guidelines committee will review the guideline.  If approved for Official Endorsement or Affirmation of Value, the Practice Guidelines committee will send its recommendation to the AAPM&R Board of Directors for final endorsement or affirmation. At the committee’s discretion, requests for review may not be granted review. Documents submitted for AAPM&R endorsement should be sent to the Practice Guidelines Committee, American Academy of Physical Medicine and Rehabilitation, 9700 West Bryn Mawr Avenue, Suite 200, Rosemont, IL, 60018.

Actions that AAPM&R may take to endorse and disseminate guidelines:

  • Official AAPM&R endorsement:
    • Fully meets AAPM&R standards; AAPM&R can endorse all of the recommendations.
    • AAPM&R full partner in development of the document
      • May bear AAPM&R logo; maybe published in thePM&R - The journal of injury, function and rehabilitationas official AAPM&R policy.If article is published in thePM&R - The journal of injury, function and rehabilitationand in journals of collaborating organizations, publication should occur simultaneously.
    • AAPM&R provided an official representative to the development of the document
      • May bear AAPM&R logo; AAPM&R may disseminate the document to its members with the permission of the primary organization. AAPM&R may request permission to publish all, a portion of or a summary of the document on the AAPM&R website after publication of the article by the primary organization.
    • AAPM&R not officially involved in the development of the document
      • May bear AAPM&R logo; AAPM&R may disseminate the document with the permission of the primary organization. AAPM&R may request permission to publish all, a portion or a summary of the document on the AAPM&R website after publication of the article by the primary organization.
  • Affirmation of Value to Physiatrists
    • Either does not fully meet AAPM&R standards, or AAPM&R cannot endorse all of the recommendations. However, AAPM&R leadership feels it is of benefit to the membership.
    • AAPM&R full partner in development of the document
      • AAPM&R may distribute the guideline to its membership via the AAPM&R website as an “educational tool”. The document may list the AAPM&R as an official contributor but not state that the AAPM&R endorses the document. AAPM&R logo may not be used.
    • AAPM&R provided an official representative to the development of the document
      • AAPM&R may distribute the guideline to its membership via the AAPM&R website as an “educational tool”. The document may state that the AAPM&R provided a representative to the development of the guideline, but may not state that the AAPM&R endorses the document. AAPM&R logo may not be used.
    • AAPM&R not officially involved in the development of the document
      • AAPM&R may distribute the guideline to its membership via the AAPM&R website as an “educational tool”. The document may not state that AAPM&R endorses the document. AAPM&R logo may not be used.
  • No endorsement
    • Does not meet AAPM&R standards; not felt to be of benefit to the membership of the AAPM&R.
    • AAPM&R full partner in development of the document; AAPM&R provided an official representative to the development of the document; AAPM&R not officially involved in the development of the document
      • AAPM&R imprimatur may not be used. AAPM&R will not disseminate the document to its membership. The document may not state that the AAPM&R endorses the doc