Evidence & Practice Committee
EVIDENCE AND PRACTICE COMMITTEE
The American Congress of Rehabilitation Medicine (ACRM) advocates that rehabilitation programs and individual practitioners base their clinical activities on the best research evidence available. ACRM and its members often have a role in the creation, evaluation and dissemination of evidence. We strive to apply the highest standards of rigor to the evaluation of research evidence and its application in rehabilitation clinical practice. ACRM established the Evidence and Practice Committee (EPC) to provide advice on all issues relevant to the collection, evaluation, and dissemination of evidence and the practice guidelines based upon it.
The EPC has primary responsibility for:
- Promote effective and efficient rehabilitation practice and enhance the quality of rehabilitation services through evidence-based practice
- Act as an oversight body to ensure that standards are met in systematic reviews and related practice recommendations or guidelines developed by ACRM members or endorsed by the ACRM
- Facilitate development of products such as practice guidelines, systematic reviews, position statements, and consumer materials
- Steward the publication of ACRM clinical practice guidelines in the Archives of PM&R
As a component of an interdisciplinary organization, the EPC has reviewed the validity of nationally and internationally respected approaches to evidence synthesis. The EPC has selected the methodology developed by the American Academy of Neurology (AAN) as the preferred way of developing guidelines for rehabilitation professionals. While the AAN method is the preferred basis, reviews and guidelines developed using other recognized evidence-based methods such as those of the Cochrane Collaboration, the Appraisal of Guidelines for Research and Evaluation (AGREE) collaboration, Grades of Recommendation, Assessment, Development, and Evaluation (GRADE), the Institute of Medicine, and the Agency for Healthcare Research and Quality are considered acceptable when seeking ACRM endorsement. The EPC also develops materials and standards to improve the synthesis of research information and its application to rehabilitation in practice.
- Renewed gifts from CARF and Paradigm with more well-defined expectations for performance and accounting: (identifying a discrete set of projects, funding amounts and timelines with target date of mid-November to finalize)
- Near finalized projects:
- “Use of Mixed Norepinephrine and Dopamine Reuptake Inhibitors for TBI”: (1) Systematic Review draft is complete and ready for EPC Scientific Subcommittee review, (2) Practice Guideline is near complete, finalizing three paragraphs, and (3) EPC Scientific Subcommittee review of SR&PG will be led by James Graham, verifying SME reviewers
- “Searching the grey literature best practice” manuscript: Archives submission pending (revising the manuscript with additional references; if not accepted by Archives, then will be published as technical report by KTDRR)
- Supported, consulted on, or evaluated ~10 guideline/case definition projects for BOG endorsement, including:
- Silverberg et al. (Case Definition of Mild TBI): Task force working on case definition manuscript, EPC will review when complete
- ACRM Pain NG (Conservative Interventions for Fear in Chronic Low Back Pain): Ron updating evidence synthesis table provided by panel
- Goldin et al. (Cognitive Rehabilitation Guidelines, 5th revision): Determining funding level required
- Page et al. (Practice Advisory on Hyperbaric Oxygen for Stroke Outcomes)
- Reviewed current systematic reviews published in Archives of PM&R as potential basis for practice advisory development:
- ~80 systematic reviews screened; ~20 SRs reviewed by P&D Subcommittee with 5-8 identified as priority SRs for advisories
- Science Subcommittee reviewed SR quality and work required and only 1 of 8 can be “flipped” into practice recommendations
- Exploring guideline potential of topics generated by Science and P&D Subcommittees, including:
- “Best Practices in Informal Caregiving Education and Training for People with Disabilities”
- “Emerging Standards in COVID-19 Rehabilitation” (Placed on hold but we are re-examining based on long-COVID #’s and economic impact).
- Presented to Chairs Council with goal of inviting input on topics of interest from ACRM Com
- Continue to facilitate, produce, and disseminate evidence-based products such as ACRM-endorsed guidelines, position statements, case definitions, and more
- Re-establish EPC education and training on systematic reviews and practice guideline/advisory development
- EPC Funding
- Using different model, allocate funding per project in advance
- Approve practice guideline development plans for 2023-2024
- Create multi-year strategic plan based on approved projects
- ACRM EPC Process for obtaining input from Community Groups
- Codify solicitation process
- Seek additional methods for regular (monthly) EPC communication to interested parties
- Expand subcommittee membership and evolve leadership structure in which duties of subcommittee chairs (Science, P&D) have less overlap with EPC chair
Exciting Opportunity for Guideline Developers
ACRM, CARF International and Paradigm are promoting an evidence-based practice initiative to co-fund, develop, translate, brand, and disseminate high-quality, clinical practice guidelines. This initiative falls under the administration of the ACRM Evidence and Practice Committee (EPC). The ACRM EPC is comprised of the Science Subcommittee and the Policy and Dissemination Subcommittee. CARF International and Paradigm have input and are active in the Policy and Dissemination Subcommittee.
All ACRM Special Interest and Networking groups are eligible to participate in this initiative. We provide technical support and can potentially fund systematic reviews and clinical practice guideline development. If you have evidence-based projects under way, this initiative may be able to facilitate and move along your project in a more expedient way.
As collaborators in this initiative, the following benefits are available:
- ACRM EPC would facilitate guideline development and dissemination using both internal and contract resources; facilitate a streamlined and defined guideline development process
- CARF International would disseminate practice guidelines to both accredited organizations and those interested in accreditation and also if possible translate the guidelines into standards as appropriate and track the conformance to those standards over time.
- Paradigm would disseminate and train providers on guidelines, track adoption and evaluate outcomes against their historical data.
ACRM-CARF International and Paradigm are excited about this initiative to leverage our resources and expertise to connect with you on the development of practice guidelines and evidence-based practice products. If you have an idea, please submit it here.
Cochrane Library contains all the SRs completed by the numerous Cochrane groups.
The Campbell Library contains SRs of interventions in the areas of education, social welfare, and crime and justice.
Center on Knowledge Translation for Disability and Rehabilitation Research (KTDRR)
Policy and Dissemination
The ACRM EPC Policy and Dissemination (P&D) Subcommittee is to maximize the dissemination and policy impact of ACRM evidence-based products including but not limited to practice guidelines, systematic reviews, and position statements. The P&D has three primary functions. First, the P&D identifies and recommends high impact rehabilitation topics, and evaluates and prioritizes topics submitted by ACRM members for practice guideline (PG) development. Second, P&D evaluates the usability of PG products prior to the project beginning and before publication to assure it will serve a broad set of stakeholders. The P&D does not change PG recommendations but rather ensures that the evidence-based recommendations are described in a way that stakeholders will be able to implement it in everyday practice. Lastly, the P&D provides input on approved evidence-based recommendation dissemination plans to assure they appropriately target relevant stakeholders in the care continuum and maximizes potential adoption and policy changes. Examples of dissemination products include but are not limited to stories in eNews, ACRM eblasts, social media, podcasts, as well as the development of more advanced products and plans such as translational documents, webinars, policy statements, and dissemination to networks outside of ACRM.
Terrence Carolan is Managing Director of Medical Rehabilitation for CARF International after being a CARF surveyor for 10 years. Prior to his role as Managing Director, Terrence worked at Select Medical and Kessler Institute for Rehabilitation for 20 years as a physical therapist, clinical manager, Director of Education and Assistant Vice President of Education for the Inpatient Rehabilitation Division of Select Medical. Terrence received a Bachelor of Science in Biology from The College of New Jersey, a Master of Science in Physical Therapy from Simmons College and will receive a Master of Business Administration from University of Wisconsin, Eau Claire in May, 2022.
Anne Deutsch is a Senior Research Public Health Analyst at RTI International. She also has an appointment as a Clinical Research Scientist at the Shirley Ryan Abilitylab (formerly the Rehabilitation Institute of Chicago) in the Center for Rehabilitation Outcomes Research and she is a Research Associate Professor in the Department of Physical Medicine and Rehabilitation in Northwestern University’s Feinberg School of Medicine. She is a certified rehabilitation registered nurse with a doctoral degree in Epidemiology and Community Health. Anne’s research has focused on Medicare payment and quality of care policies. This work has led to the development and implementation of standardized data elements in post-acute care (inpatient rehabilitation facilities, long-term care hospitals and skilled nursing facilities), the implementation of the “IRF Compare” and “LTCH Compare” websites, as well as confidential feedback reports for providers. Anne led the team that developed the IRF self-care and mobility functional outcome measures, which are endorsed by the National Quality Forum, and have been implemented as IMPACT Act quality measures. Anne has served on many expert panels, including the panels sponsored by the Institute of Medicine, the Centers for Medicare and Medicaid Services, the National Quality Forum, the Medicare Payment Advisory Commission, the Administration for Community Living and the World Health Organization.
The ACRM EPC Science Subcommittee oversees the scientific evaluation and development of evidence-based products (e.g. practice guidelines, position statements, systematic reviews, etc.) designed to promote effective and efficient rehabilitation practices and enhance rehabilitation services. The subcommittee provides on-going scientific consultation and acts as an oversight body to ensure that research quality standards are met in the creation ACRM practice guidelines, systematic reviews and other documents. The EPC Science subcommittee evaluates all guidelines or recommendations developed by other organizations proposed for ACRM endorsement and provides recommendations to the ACRM Board regarding approval. The EPC Science Subcommittee also develops scientific methodological materials and standards to improve the synthesis of research information and its application to rehabilitation practice. The committee collaborates with the editorial boards of the ACRM journals, the Archives of Physical Medicine and Rehabilitation and the Archives of Rehabilitation Research and Clinical Translation, as well as the ACRM EPC Policy and Dissemination Subcommittee as needed to publish these products.
Dr. Goldin is a senior clinical and research neuropsychologist at JFK Johnson Rehabilitation Institute, JFK University Medical Center and Assistant Clinical Professor of Physical Medicine and Rehabilitation at Rutgers Robert Wood Johnson Medical School. She has extensive experience clinical work and research in brain injury, aging, and sex & gender issues. Dr. Goldin is the Project Director of the JFK Johnson TBI Model System center, training director of JFK Johnson clinical neuropsychology residency, and responsible for research training of the JFK Johnson PM&R medical residents and fellows.
She has been an active member of the American Congress of Rehabilitation Medicine for 10 years, where, in addition to the Scientific Subcommittee, she also serves on the Program Committee, chairs the Poster Committee, and is co-chair BIISIG’s Cognitive Rehabilitation Task Force and the Girls and Women with ABI task force.
Mark V. Johnston, PhD, FACRM, Professor Emeritus. Mark Johnston’s research has centered about questions of measurement of activity, health, and quality of life outcomes after health-related rehabilitation; factors predicting or determining these outcomes, including personal factors and care system factors; evaluation of the effectiveness of interventions using both experimental and quasiexperimental research designs; and the synthesis and utilization of best evidence practice, that is, evidence-based practice. His research has addressed the needs of people with many types of disability and chronic-illnesses but has particularly focused on activity-based interventions for groups with neurological disabilities, such as traumatic brain injury, spinal cord injury and stroke. He is former chair of the ACRM Evidence and Practice Committee.
Joseph T. Giacino, PhD, FACRM is the Director of Rehabilitation Neuropsychology at Spaulding Rehabilitation Hospital (SRH), Consulting Neuropsychologist in the Department of Psychiatry at Massachusetts General Hospital, Professor of Physical Medicine and Rehabilitation at Harvard Medical School (HMS) and Adjunct Professor at the MGH Institute of Health Professions. He is also on the faculty of the Center for Bioethics at HMS where he teaches Neuroethics and serves as a Capstone Seminar mentor for Master’s degree candidates. He directs the SRH Neurorehabilitation Laboratory which seeks to develop more precise neurodiagnostic procedures, clinical outcome assessment measures and treatment interventions for persons with severe acquired brain injury and disorders of consciousness (DoC). He is the Project Director of the Spaulding-Harvard Traumatic Brain Injury Model System (NIDILRR, 2012-2022) and co-leads the Outcomes Core of the “Transforming Research and Clinical Knowledge in TBI” (NINDS, 2013-2018) and “TBI Endpoint Development (DoD, 2014-2019) projects, which aim to validate clinical, imaging, and genomic biomarkers to improve TBI diagnosis, prognosis and treatment. He also serves as Co-PI on a pilot clinical trial assessing, “Central Thalamic Stimulation for Traumatic Brain Injury” (NINDS, 2015-2020) and recently completed a DoD-funded project that developed an Evidence-Based Clinical Outcome Assessment Platform (“EB-COP”) for systematic evaluation of TBI outcome measures. He led the expert panels that established the diagnostic criteria for the minimally conscious state and developed the 2018 Practice Guideline on Disorders of Consciousness, co-sponsored by the American Academy of Neurology, American Congress of Rehabilitation Medicine and National Institute on Disability Independent Living and Rehabilitation Research. Dr. Giacino maintains a broad array of national and international collaborations aimed at improving care for patients with severe TBI.
ACRM Review System
- Matrix of endorsement categories
- Clinical Practice Guideline Process Manual, 2017 Ed. St. Paul, MN
- Systematic Review Project Development Form
- Systematic Review Budget Request Form
- ICM JE Conflict of Interest and Disclosure Forms
ACRM Member Guide to Product Development
The Member Guide to Product Development, managed by the ACRM Communications Committee, describes ACRM products, e.g., fact sheets, journal articles, manuals, and the procedure used by ACRM groups and committees to develop them. Includes a product development worksheet and a form to request a product review.
ACRM ENDORSED GUIDELINES
Guidelines & Reviews
– Communication Partner Training in Aphasia: A Systematic Review
Nina Simmons-Mackie, Anastasia Raymer, Elizabeth Armstrong, Audrey Holland, Leora R. Cherney
– Communication Partner Training in Aphasia: An Updated Systematic Review
Nina Simmons-Mackie, Anastasia Raymer, Leora R. Cherney
- DOC Assessment Parameter
- Practice Guideline Update Recommendations Summary: Disorders of Consciousness
Joseph T. Giacino et al
- Comprehensive Systematic Review Update Summary: Disorders of Consciousness
Joseph T. Giacino et al
- Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014
Keith D. Cicerone, Yelena Goldin, Keith Ganci, Amy Rosenbaum, Jennifer V. Wethe, Donna M. Langenbahn, James F. Malec, Thomas F. Bergquist, Kristine Kingsley, Drew Nagele, Lance Trexler, Michael Fraas, Yelena Bogdanova, J. Preston Harley
- Mild TBI Definition
- Aspen Guidelines MCS and Emerged
- Minimum Competency Recommendations for Programs That Provide Rehabilitation Services for Persons With Disorders of Consciousness
Joseph T. Giacino et al
- Post-traumatic Confusional State: A Case Definition and Diagnostic Criteria
Mark Sherer, Douglas I. Katz, Yelena G. Bodien, David B. Arciniegas, Cady Block, Sonja Blum, Matt Doiron, Kim Frey, Joseph T. Giacino, Min Jeong P. Graf, Brian Greenwald, Flora M. Hammond, Kathleen Kalmar, Jacob Kean, Marilyn F. Kraus, Risa Nakase-Richardson, Shital Pavawalla, Amy Rosenbaum, Donald T. Stuss, Stuart A. Yablon
EPC Sponsored Supplement for Improving Development and Use of Evidence
- Seel RT, Dijkers MP, Johnston MV. Developing and using evidence to improve rehabilitation practice. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S97-100.
- Whyte J, Barrett A. Advancing the evidence base of rehabilitation treatments: a developmental approach. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S101-10.
- Graham JE, Karmarkar AM, Ottenbacher KJ. Small sample research designs for evidence-based rehabilitation: issues and methods. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S111-6.
- Hart T, Bagiella E. Design and implementation of clinical trials in rehabilitation research. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S117-26.
- Horn SD, DeJong G, Deutscher D. Practice-based evidence research in rehabilitation: an alternative to randomized controlled trials and traditional observation studies.Arch Phys Med Rehabil 2012;93(8 Suppl 2):S127-37.
- Seel RT, Steyerberg EW, Malec JF, Sherer M, Macciocchi SN. Developing and evaluating prediction models in rehabilitation populations. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S138-53.
- Velozo CA, Magasi S, Heinemann AW, Romero S, Seel RT.Improving measurement methods in rehabilitation: core concepts and recommendations for scale development. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S154-63.
- Dijkers MP, Murphy SL, Krellman J. Evidence-based practice for rehabilitation professionals: concepts and controversies. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S164-76.
- Johnston MV, Dijkers MP. Toward improved evidence standards and methods for rehabilitation: recommendations and challenges. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S185-99.
- Dijkers MP, Bushnik T, Heinemann AW, Heller T, Libin AV, Starks J, Sherer M, Vandergoot D.Systematic reviews for informing rehabilitation practice: an introduction. Arch Phys Med Rehabil 2012;93:912-8.
- Brown PA, Harniss MK, Schomer KG, Feinberg M, Cullen NK, Johnson KL.Conducting systematic evidence reviews: core concepts and lessons learned. Arch Phys Med Rehabil 2012;93(8 Suppl 2):S177-84.
Agency for Healthcare Research and Quality (AHRQ)*
The EBP section lists all SRs completed by the AHRQ funded Evidence-based Practice Centers.
American Speech-Language-Hearing Association
“Systematic Reviews” lists published SRs on speech, language, and hearing issues that have been evaluated by Association staff.
Centre for Reviews and Dissemination*
The Database of Abstracts of Reviews of Effects is focused primarily on SRs that evaluate the effects of health care interventions and the delivery and organization of health services.
Centre for Reviews and Dissemination*
Health Technology Assessments (HTAs) supplied by the members of the International Network of Agencies for Health Technology Assessment and other HTA organizations around the world.
Cumulative Index to Nursing and Allied Health Literature (CINAHL)
A database of peer-reviewed and other literature of nursing and allied health disciplines. In “advanced search,” under “publication type,” select “systematic review.”
Education Resources Information Center (ERIC)*
Use key word “systematic review” with other terms in “advanced search.” (ERIC includes records of the What Works Clearinghouse.)
Evidence for Policy and Practice Information and Coordinating (EPPI) Centre*
The EPPI Library holds SRs in the fields of education, health promotion, and public health.
Evidence-Based Review of Moderate To Severe Acquired Brain Injury*
An evidence-based review of the literature for rehabilitation or rehabilitation-related interventions for acquired brain injury.
Joanna Briggs Institute*
Library of Systematic Reviews contains documents reporting on SRs of quantitative or qualitative studies of health care practices and therapeutics.
National Institute for Health and Clinical Excellence*
Guidelines documents contain SRs of the topic.
National Rehabilitation Information Center*
A database of publications resulting from research funded by the National Institute on Disability and Rehabilitation Research, as well as other documents relevant to disability and rehabilitation. Under “research publications” in the “researchers” tab, enter “systematic review.”
Registry of SRs of disability and rehabilitation research.
On the search page, the “Method” specification allows one to select SRs “relevant to occupational therapy.”
PEDro Physiotherapy Evidence Database*
On the search page, the “Method” specification allows one to select SRs in the area of physical therapy.
PROSPERO is a registry of planned and in-progress health care SRs, providing their protocol.
On the search page, the “Method” specification allows one to select SRs in the area of cognitive, behavioral, and other treatments for psychological problems and issues occurring as a consequence of acquired brain impairment.
PsycINFO (OVID platform)
A database of peer-reviewed literature in psychology and many related disciplines. Type “systematic review.mp” into the search box, and combine with other key words and thesaurus terms to narrow the search.
“Clinical Queries” function is optimized to filter “systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, and guidelines.”
Social Care Institute for Excellence*
The library contains SRs of “social care services”: the entire range of social and related services used by people with disabilities.
On the search page, the “Method” specification allows one to select SRs in the area of speech pathology.
Spinal Cord Injury Rehabilitation Evidence (SCIRE) project*
SCIRE reviews, evaluates, and translates research knowledge into formats to inform health professionals and other stakeholders of best rehabilitation practices after SCI.
Have a Practice Guideline Idea?
Submit your Systematic Review or Guideline Idea
ACRM Systematic Reviews & Guidelines Development
If you have systematic reviews or guideline development activities planned or already underway, please provide us the following information. We are looking forward to having your input and involvement in this exciting project.