Permanent Scientific Committee (PSC)

Update

June 2009

PSC

Meeting October 23rd Rotterdam

Ragnhild Cederlund (Sweden)Firdevs Kul (Turkey)Jean-Claude Rouzand (France)Ursula Wendling-Hosch (Switzerland)Turid Aasheim (Norway)Ton Schreuders (the Netherlands)

• EFSHT congresses Lausanne meeting 2009Oslo meeting 2011

• EUROPEAN HAND THERAPY GUIDELINES update project

Hand Guide Project

• International developmentsICF core set upper extremity ( WHO) ASHT plans

269 participants28 countries

118 abstracts

accepted-77 presentations-17 posters

Reviewing process-amount of topics-workshops

Delphi round in Mallet finger for EFHST consensus

25 experts, appointed by their national hand therapy federation (members of EFSHT) were involved in this Delphi survey on Mallet finger.

Eurohand 2011

Oslo 26 -28 May

EUROPEAN HAND THERAPY GUIDELINES

• update project

Hand Guide Project

Reviews

Experts

Cooperation hand surgeons and Rehab drs

Clinical practice guidelines (CPGs)

systematically developed statements to assist practitioners and patients on healthcare decisions

provide recommendations for the average patient, which should take into account individual clinical judgment and the patient’s values and expectations

Lopez-Olivo MA, Suarez-Almazor ME. Developing guidelines in musculoskeletal disorders. Clinical and experimental rheumatology. 2007 Nov-Dec;25(6 Suppl 47):28-36.

Clinical practice guidelines (CPGs)

WHO Criteria• CPGs should be produced under the auspices of medical specialty

associations; relevant professional societies (eg EFSHT), public or private organizations, government agencies at the federal, state, or local level; or healthcare organizations or plans.

• During guideline development, a systematic literature search and/or review of the existing scientific evidence published in peer-reviewed journals should be performed.

• The full text guideline should be available upon request in print or electronic format in the English language.

• Evidence that the guideline was developed, reviewed, or revised and updated should be documented.

existing scientific evidence

4 levels of evidence

A1 systematic reviews

A2 randomised controled trials (RCT)

B trials of poor quality or small groups

(cohort, patientgroups)

D expert opinion

4 levels of evidence

A1 systematic reviews

A2 randomised controled trials (RCT)

B trials of poor quality or small groups

(cohort, patientgroups)

D expert opinion

EUROPEAN HAND THERAPY GUIDELINES

Ms Bionka Huisstede, ErasmusMC• PT, PhD in 2007 on Complaints of the Arm,

Neck and/or Shoulder (CANS) • funding 3 years • Reviews on CTS, Guyon canal syndrome, De

Quervain, Trigger Finger and Dupuytren

Proposal start with CPGs on:

• tendinitis– De Quervain– Trigger Finger

• Dupuytren

• entrapments– Carpal tunnel syndrome– Guyon canal syndrome

• EFSHT - The European Federation of Societies for Hand Therapy

• FESSH - Federation of European Societies for Surgery of the Hand

• ESPRM - European Society of Physical and Rehabilitation Medicine

Proposal cooperation with:

existing scientific evidence

4 levels of evidence

A1 systematic reviewsA2 randomised controled trials (RCT)B trials of poor quality or small groups

(cohort, patientgroups)

D expert opinion

4 levels of evidence

A1 systematic reviewsA2 randomised controled trials (RCT)B trials of poor quality or small groups

(cohort, patientgroups)

D expert opinion

Expert opinion by Delphi roundsSelection of experts

Requirements expert panel:

An expert should be • a medical or paramedical healthcare professionals with significant

experience (xx years) in treating patients with the non-traumatic hand disorders (e.g. Dupuytren’s disease)

• considered to be key persons in the field of non-traumatic hand disorders by their own professional discipline

• have basic knowledge on evidence based practice. • each country can be represented by a maximum of xx member(s).

AGREE

Appraisal of Guidelines Research & Evaluation

Instrument to judge guidelines

The AGREE Research Trust www.agreetrust.org

Proposal

• Start finding reviewers for traumatic conditions– Nerve– Fractures– Tendon– Joints (capsule, ligament)– RA

• EFSHT congresses Lausanne meeting 2009Oslo meeting 2011

• EUROPEAN HAND THERAPY GUIDELINES update project

Hand Guide Project

• International developmentsICF core set upper extremity ( WHO) ASHT plans

ICF Core Set Developmentfor Clinical Practice

ICF Research Branch WHO Collaborating Center for the Family of

Classifications Germany (DIMDI) at the University of Munich

WHOCAS Classification, Assessment Surveys

define

what should be measuredand not how to measure

ICF

a framework which uses unifying terminology for the classification of diseases and their effect on – body structure /functioning – activities – participation

Development of ICF Core Sets for Hand Conditions

• Approval of the International Classification of Functioning, Disability, and Health (ICF) by WHO

• universally accepted framework to classify and describe functioning, disability and health in individuals with conditions of the hand

• Objective: development of ICF Core Sets for Hand Conditions.

ICF Consensus ConferenceMay 2009 in collaboration with WHO, Nottwil, Switzerland. Aim: decide on the first version of ICF Core Sets for Hand Conditions.

The group of experts was an International, multi-disciplinary and multi-cultural company of 23 participants. There were 5 Occupational Therapists, 6 Physical Therapists, 6 physicians, 3 psychologists, 1 social worker and 2 nurses.

• Following a strict procedure and method with several working groups, discussions, plenary sessions and by voting the first Core Set for Hand Conditions is accomplished.

• Now a validation study will be conducted by the research group

ASHT

new President of the ASHT Joy MacDermid

update of the Clinical Recommendation on Assessment of the Hand

MacDermid JC. The quality of clinical practice guidelines in hand therapy. J Hand Ther. 2004 Apr-Jun;17(2):200-9.

ASHT plans

instruments

International

C. Jerosh-Herold

L. van de Ven-Stevens*

W. Brandsma/Schreuders

* Lucelle van de Ven-Stevens (OT, MSc) from the Radboud University Nijmegen Medical Centre, the Netherlands. -article in the British Journal of Hand Therapy (Spring 2007) on the subject: Assessment of Activities in Patients with Hand Injury: A Review of Instruments in Use. -clinimetric review of 23 selected instruments for the assessment of activities in hand injury, using the quality criteria-list for instrument properties