National Guideline Clearinghouse

The National Guideline Clearinghouse (NGC) is an initiative of the Agency for Healthcare Research and Quality (AHRQ) External Web Site Policy, U.S. Department of Health and Human Services. NGC was originally created by AHRQ in partnership with the American Medical Association and the American Association of Health Plans (now America’s Health Insurance Plans [AHIP]). The NGC mission is to provide physicians and other health care professionals, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use.


Updated Summary: Knee stability and movement coordination impairments: knee ligament sprain revision 2017. [American Physical Therapy Association, Inc., The Orthopaedic Section]

Not applicable: The guideline was not adapted from another source. American Physical Therapy Association, Inc., The Orthopaedic Section – Medical Specialty Society The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc. Clinical Practice Guideline (CPG) Development Team Authors: David S. Logerstedt, PT, PhD, Assistant Professor, Department of Physical […]


Updated Summary: Hip pain and mobility deficits—hip osteoarthritis: revision 2017. [American Physical Therapy Association, Inc., The Orthopaedic Section]

Levels of evidence (I–V) and grades of recommendation (A–F) are defined at the end of the “Major Recommendations” field. Note: These recommendations and clinical practice guidelines are based on the scientific literature published prior to April 2016. Please refer to the American Physical Therapy Association’s (APTA’s) previously published guidelines on […]


Updated Summary: Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity: a report of the American Dental Association. [American Dental Association]

Major Recommendations Definitions for the quality of the evidence (High, Moderate, Low, Very Low) and the strength of recommendations (Strong, Conditional) are provided at the end of the “Major Recommendations” field. Summary of Good Practice Statements and Clinical Recommendations for the Evaluation of Potentially Malignant Disorders and Oral Squamous Cell […]


New Summary: Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. [American Psychological Association]

Major Recommendations Psychotherapy For adult patients with posttraumatic stress disorder (PTSD), the panel strongly recommends that clinicians offer one of the following psychotherapies/interventions (listed alphabetically): Cognitive behavioral therapy (CBT)* Cognitive processing therapy (CPT) Cognitive therapy (CT) Prolonged exposure therapy (PE) (Strength of Recommendation: Strong For) For adult patients with PTSD, […]


New Summary: Use of vital pulp therapies in primary teeth with deep caries lesions. [American Academy of Pediatric Dentistry]

Not applicable: The guideline was not adapted from another source. The guideline was funded by the American Academy of Pediatric Dentistry, a dental specialty organization of over 10,000 members. Vital Pulp Therapy Workgroup Workgroup Members: Vineet Dhar, BDS, MDS, PhD (Vital Pulp Therapy Workgroup Chair), clinical associate professor and chief, […]


New Summary: Use of silver diamine fluoride for dental caries management in children and adolescents, including those with special health care needs. [American Academy of Pediatric Dentistry]

Not applicable: The guideline was not adapted from another source. The preparation of this guideline was funded by the American Academy of Pediatric Dentistry, a dental specialty organization with over 10,000 members. Silver Diamine Fluoride (SDF) Workgroup Workgroup Members: Yasmi O. Crystal, DMD, MSc, FAAPD (Workgroup Chair), clinical associate professor […]


New Summary: Oral health management of patients at risk of medication-related osteonecrosis of the jaw. [Scottish Dental Clinical Effectiveness Programme]

Major Recommendations Note from the Scottish Dental Clinical Effectiveness Programme (SDCEP) and National Guideline Clearinghouse (NGC): In addition to these key recommendations, the guideline development group also identifies clinical practice advice, designated by a molar icon, in the full-text guideline document. Classification of Patient Risk Assessing Patient Risk Assess whether […]


New Summary: Conscious sedation in dentistry. [Scottish Dental Clinical Effectiveness Programme]

Note from the Scottish Dental Clinical Effectiveness Programme (SDCEP) and National Guideline Clearinghouse (NGC): In addition to these key recommendations, the guideline development group also identifies clinical practice advice, designated by a molar icon, in the full-text guideline document. Environment for Conscious Sedation Ensure that the clinical environment for the […]


New Summary: Classification of cough as a symptom in adults and management algorithms: CHEST guideline and Expert Panel report. [American College of Chest Physicians]

Literature Search The methods used for this systematic review conformed to those outlined in the article “Methodologies for the Development of CHEST Guidelines and Expert Panel Reports” (see the “Availability of Companion Documents” field). Librarians from the University of Massachusetts Medical School undertook searches to answer the question for acute, […]


Updated Summary: Practice advisory for the prevention of perioperative peripheral neuropathies 2018: an updated report by the American Society of Anesthesiologists Task Force on Prevention of Perioperative Peripheral Neuropathies. [American Society of Anesthesiologists]

In 2016, the American Society of Anesthesiologists (ASA) Committee on Standards and Practice Parameters requested that scientific evidence for this Advisory be updated. The update consists of an evaluation of literature that includes new studies obtained after publication of the original Advisory. State of the Literature For the systematic review, […]


Updated Summary: Role of bone-modifying agents in metastatic breast cancer: an American Society of Clinical Oncology–Cancer Care Ontario focused guideline update. [American Society of Clinical Oncology]

Major Recommendations Definitions for the rating of evidence (High, Intermediate, Low, Insufficient); types of recommendations (Evidence based, Formal consensus, Informal consensus, No recommendation); and strength of recommendations (Strong, Moderate, Weak) are provided at the end of the “Major Recommendations” field. Clinical Question 1 What are the best intervals between dosing […]


Updated Summary: Evidence-based clinical practice guideline: autologous breast reconstruction with DIEP or pedicled TRAM abdominal flaps. [American Society of Plastic Surgeons]

Not applicable: The guideline was not adapted from another source. This clinical practice guideline was funded exclusively by the American Society of Plastic Surgeons; no outside commercial funding was received to support the development of this article. Work Group Members: Bernard T. Lee, M.D., M.B.A., M.P.H. (Work Group Chair); Jayant […]


New Summary: Clinical policy: emergency department management of patients needing reperfusion therapy for acute ST-segment elevation myocardial infarction. [American College of Emergency Physicians]

Not applicable: The guideline was not adapted from another source. The American College of Emergency Physicians was the funding source for this clinical policy. American College of Emergency Physicians (ACEP) Clinical Policies Subcommittee (Writing Committee) on Reperfusion Therapy for Acute ST-Segment Elevation Myocardial Infarction ACEP Clinical Policies Committee (Oversight Committee) […]


Updated Summary: Final recommendation statement: adolescent idiopathic scoliosis: screening. [U.S. Preventive Services Task Force]

Major Recommendations The U.S. Preventive Services Task Force (USPSTF) grades its recommendations (A, B, C, D, or I) and identifies the levels of certainty regarding net benefit (High, Moderate, and Low). The definitions of these grades can be found at the end of the “Major Recommendations” field. Recommendation Summary The […]


Updated Summary: Final recommendation statement: hormone therapy in postmenopausal women: primary prevention of chronic conditions. [U.S. Preventive Services Task Force]

Major Recommendations The U.S. Preventive Services Task Force (USPSTF) grades its recommendations (A, B, C, D, or I) and identifies the levels of certainty regarding net benefit (High, Moderate, and Low). The definitions of these grades can be found at the end of the “Major Recommendations” field. Recommendation Summary The […]


Updated Summary: Final recommendation statement: vision in children ages 6 months to 5 years: screening. [U.S. Preventive Services Task Force]

Major Recommendations The U.S. Preventive Services Task Force (USPSTF) grades its recommendations (A, B, C, D, or I) and identifies the levels of certainty regarding net benefit (High, Moderate, and Low). The definitions of these grades can be found at the end of the “Major Recommendations” field. Recommendation Summary The […]


Updated Summary: VA/DoD clinical practice guideline for rehabilitation of individuals with lower limb amputation. [Department of Veterans Affairs]

Developing the Scope and Key Questions The Clinical Practice Guideline (CPG) Champions, along with the Work Group, were tasked with identifying key questions (KQs) to guide the evidence review of the literature on lower limb amputation (LLA). These questions, which were developed in consultation with the Lewin team, addressed clinical […]


Updated Summary: VA/DoD clinical practice guideline for diagnosis and treatment of low back pain. [Department of Veterans Affairs]

Major Recommendations Note from the Department of Veterans Affairs and the Department of Defense (VA/DoD) and the National Guideline Clearinghouse (NGC): The recommendations for the diagnosis and treatment of low back pain are organized into 7 sections (A-G below) and 2 modules with 2 algorithms. The accompanying recommendations are provided […]


Updated Summary: Nonpharmacologic pain interventions: a review of evidence-based practices for reducing chronic cancer pain. [Oncology Nursing Society]

Note from the National Guideline Clearinghouse (NGC): Refer to the original guideline document for full dosages, references, and other essential information about the evidence. The recommendation ratings (Recommended for Practice, Likely To Be Effective, Effectiveness Not Established, Effectiveness Unlikely, Not Recommended for Practice, Expert Opinion) are defined at the end […]