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 process 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
Peer-Reviewed Evidence vs. Expert Consensus
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 endorsed 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 on 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.
Documents submitted for AAPM&R endorsement should be sent to:
Clinical Practice Guidelines Committee
American Academy of Physical Medicine and Rehabilitation
9700 West Bryn Mawr Avenue
Rosemont, IL, 60018
Upon receipt of a request for endorsement, The Clinical Practice Guidelines (CPG) committee or a member of the committee will undertake a screening review of the guideline for interest and priority and will generally schedule a review of the guideline. However, at the CPG committee’s discretion, not all requests for review need to be accepted. If reviewed and approved for Official Endorsement or Affirmation of Value, the Clinical Practice Guidelines committee will send its recommendation to the AAPM&R Quality, Practice, Policy, and Research Committee (QPPR) for final endorsement or affirmation. (Note – recommendations were formerly reviewed by the AAPM&R Board of Directors but the process was changed in 2016.)
Actions that AAPM&R may take to endorse and disseminate guidelines:
- No endorsement - Does not meet AAPM&R standards; not felt to be of benefit to the membership of the AAPM&R.
- Whether AAPM&R was a full partner in development of the document, or AAPM&R provided an official representative to the development of the document, or AAPM&R was 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