Lessons Learned From Moving to Living Guidelines-The Canadian Clinical Practice Guideline for the Rehabilitation of Adults With Moderate-to-Severe TBI.

ABSTRACT

OBJECTIVE: It is often challenging for providers to remain up to date with best practices gleaned from clinical research. Consequently, patients may receive inappropriate, suboptimal, and costly care. Living clinical practice guidelines (CPGs) maintain the methodological rigor of traditional CPGs but are continuously updated in response to new research findings, changes in clinical practice, and emerging evidence. The objective of this initiative was to discuss the lessons learned from the transformation of the Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Traumatic Brain Injury (CAN-TBI) from a traditional guideline update model to a living guideline model. DESIGN: The CAN-TBI Guideline provides evidence-based rehabilitative care recommendations for individuals who have sustained a TBI. The Guideline is divided into 2 sections Section I, which provides guidance on the components of the optimal TBI rehabilitation system, and Section II, which focuses on the assessment and rehabilitation of brain injury sequelae. A comprehensive outline of the living guideline process is presented. RESULTS: The CAN-TBI living guideline process has yielded 351 recommendations organized within 21 domains. Currently, 30 recommendations are supported by level A evidence, 81 recommendations are supported by level B evidence, and 240 consensus-based recommendations (level C evidence) comprise 68% of the CAN-TBI Guideline. CONCLUSION: Given the increasing volume of research published on moderate-to-severe TBI rehabilitation, the CAN-TBI living guideline process allows for real-time integration of emerging evidence in response to the fastest-growing topics, ensuring that practitioners have access to the most current and relevant recommendations.