Major Depressive Disorder - Essay Example

Objectives were specified as: “ To summarize the specific approaches to the treatment of individuals with the major depressive disorder”2. Clinical questions covered by the guideline specifically described. 1No clinical questions were identified within the guideline presentation.3. The patients to whom the guideline(s) are meant to apply are specifically described.4The target population was identified as: “ Individuals with the major depressive disorder”4. The guideline development group includes individuals from all relevant professional groups.

3Intended users were identified as “physicians” with “psychiatry” as a clinical specialty5. The patients’ views and preferences have been sought.1The guideline used a review of pertinent literature that does not seek patient views and preferences.6. The target users of the guideline are clearly defined.4The target population was identified as: “ Individuals with the major depressive disorder”7. The guideline has been piloted among target users.1Patient resources were not available, as indicated.8. Systematic methods were used to search for evidence.

3The methods identified were: “ Review of Published Meta-Analyses and Systematic Review with Evidence Tables”9. The criteria for selecting the evidence are clearly described.4The methods used to analyze the evidence were clearly described as “ Evidence tables were developed that reviewed the key features of each identified study, including funding source, studydesign, sample sizes, subject characteristics, treatment characteristics, and treatment outcomes”10. The methods used for formulating the recommendations are clearly described.

4The methods used for formulating the recommendations are clearly described as “ Expert Consensus”11. The health benefits, side effects, and risks have been considered in formulating the recommendations.4The guidelines clearly established the need to ensure the safety of the patient and establish the appropriate setting for treatment.12. There is an explicit link between the recommendations and the supporting evidence.1“The type of evidence supporting the recommendations is not specifically stated” was noted.13. The guideline has been externally reviewed by experts prior to its publications.

4As clearly indicated, an expert consensus has been sought with external and internal peer view validations.14. A procedure for updating the guideline is provided.4As indicated, “This guideline updates a previous version: American Psychiatric Association practice guideline for the treatment of patients with major depressive disorder. Am J Psychiatry 2000 Apr;157(4 Suppl):1-45. [325 references]”15. The recommendations are specific and unambiguous.4Recommendations were comprehensive and detailed according to evaluation, management, and treatment16.

The different options for management of the condition are clearly presented.4As specifically noted: the recommendations were categorized according to endorsements as: [I] Recommended with substantial clinical confidence.[II] Recommended with moderate clinical confidence.[III] May be recommended on the basis of individual circumstances.17. The key recommendations are easily identifiable.4Recommendations are clearly and easily identifiable through appropriate sub-headings.18. The guideline is supported by tools for application.

4The guidelines noted Benefits/Harms of Implementing the Guideline Recommendations19. The potential organizational barriers in applying the recommendations have been discussed.4As noted, the harms of implementing the guideline recommendations were clearly stipulated.20. The possible cost implications of applying the recommendations have been considered.As indicated, “ a formal cost analysis was not performed and published cost analyses were not reviewed”21. The guideline presents key review criteria for monitoring and/or audit purposesQualifying statements present information for monitoring and audit of contents thereof.22. The guideline is editorially independent of the funding bodyFrom the scores rated for the guideline chosen, one strongly contents that the guideline followed the standards expected of guidelines for healthcare institutions and practitioners in terms of providing accurate and concise information on almost all items (15 out of 23) or 65%.

On the other hand, one strongly disagreed in 5 out of 23 items (22%) in the area of scope, providing no link between evidence and recommendation (but was appropriately disclosed). Further, there was only one item where one disagreed where the guideline is editorially independent of the funding body since members of the workgroup were identified to “relationships with industry for which they received research grants or income from consulting or speaking related to treatments discussed in the guideline” but was again, appropriately disclosed.