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Soft Tissue Shoulder Disorders Care Pathway

Date of last update: November, 2024

Development and Evidence Selection

The pathway integrates guidance from guidelines evaluated through the AGREE II tool, systematic reviews assessed with AMSTAR, clinical textbooks, and curricula from accredited institutions.

  • Guideline and evidence selection: Treatment recommendations are based on broad literature searches to capture current guidelines. High-quality systematic reviews were used when guidelines were unavailable.

  • Consistent recommendations: Treatments reflect consistent recommendations across multiple guidelines and systematic reviews, demonstrating evidence of benefit or harm.

  • Inconsistent or unsupported recommendations: Conflicting or evolving recommendations are addressed in these notes to focus on well-supported, evidence-driven practice.

  • Knowledge user input: Input from clinical leaders, educators, and researchers, ensures practical alignment with current evidence.

  • Updates: This pathway is updated to reflect evolving evidence, with changes communicated through social media and other channels.

Search Strategy Overview

  • Primary sources: PubMed/MEDLINE, Google Scholar, Guidelines International Network (GIN), and NICE guidelines were used to identify relevant guidelines and reviews.

  • Timeframe: Searches are limited to guidelines and reviews published within the last 10- 15 years to ensure recommendations reflect the most recent and clinically relevant evidence.

  • Search terms: Tailored to each care pathway topic, combining relevant conditions (e.g., "low back pain", "shoulder pain") with terms such as "guideline" or "systematic review".

  • Search limits: Only the top results were reviewed in each database to focus on relevant sources (e.g., first 50-100 results).

  • Manual additions: Contributions from knowledge user networks to ensure inclusion of important guidelines.

  • Documentation: Search terms, sources, and critical appraisals are documented for transparency.

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