Table 1

Characteristics of the included guidelines (n=20)

Guideline organisation/society/authorsGuideline name(s)Year of publicationTarget usersGuideline writersGuideline review processSearch strategy for evidenceLevel of evidence included*NHMRC grade of recommendation†
USA
Wheeler et al 34 Occupational Therapy Practice Guidelines for Adults with TBI2016Occupational therapists, educators, consumers, families, caregivers, third-party payers and policy-makersOccupational therapistsGuideline development groupSystematic literature reviewLevel 1–4‡NS‡
Wolf et al 35 Occupational Therapy Practice Guidelines for Adults with Stroke2015Occupational therapists, educators, clients, families, caregivers, third-party payers and policy-makersOccupational therapistsGuideline development group reviewSystematic literature reviewLevel 1–4‡A–C, I‡
DVA/DoD AHA36 Management of Stroke Rehabilitation2010Healthcare professional in stroke managementMultidisciplinaryGuideline development group reviewSystematic literature reviewLevel 1–4‡A–C, I, GPP‡
Miller et al 41 Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient: a scientific statement from the American Heart Association2010Nurses and stroke healthcare cliniciansMultidisciplinaryNSSystematic literature reviewLevel 1–4‡A–C‡
Warden et al 42 Guidelines for the Pharmacologic Treatment of Neurobehavioral Sequelae of Traumatic Brain Injury2006NSPhysiciansNSSystematic literature reviewLevel 1–4‡NS
Winstein et al 43 Guidelines for Adult Stroke Rehabilitation and Recovery2016NSMultidisciplinaryInternal and external peer reviewSystematic literature reviewLevel 1–4‡A–C‡
Australia/New Zealand
Bayley et al 31 INCOG Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: methods and overview2014Healthcare professionals, rehabilitation support workers, clients and their familiesMultidisciplinaryExternal review by journal publisherSystematic review of published guidelinesLevels 1–3.3‡A–C, GPP‡
Stroke Foundation9 Clinical Guidelines for Stroke Management2017Administrators, funders, policy makers, health professionalsMultidisciplinaryPublic consultation, consumer consultation, peer review by international expertsSystematic literature reviewLevels 1–4A-D, GPP
NZGG32 Traumatic Brain Injury: diagnosis, acute management and rehabilitation2006Health practitioners, private providers, case managers, educationalists and fundersMultidisciplinaryExternal peer review, expert peer reviewSystematic literature reviewLevels 1–3‡A–C, GPP‡
SFNZ and NZGG26 Clinical Guidelines for Stroke Management2010Health practitioners, administrators, funders and policy-makersInterdisciplinaryPublic consultation, consumer review, stakeholder reviewSystematic literature reviewLevels 1–4A–D, GPP
Canada
ABIKUS40 Evidence-Based Recommendations for Rehabilitation of Moderate to Severe Acquired Brain Injury2007Healthcare professionals, policy-makers, funding bodies, rehabilitation support workers, clients, familiesMultidisciplinaryExternal individual reviewersSystematic review of published guidelinesLevels 1–4‡E‡
CSS27 28 Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines, Update 20152016Health professionals, policy-makers, planners, funders, senior managers and administratorsMultidisciplinaryNational expert consensus meeting, external expert reviewSystematic literature reviewLevels 1–4‡A–C, GPP‡
Canadian Stroke Best Practice Recommendations: Telestroke Best Practice Guidelines Update 20172017Health professionals, policy-makers, planners, funders, senior managers and administratorsMultidisciplinaryNational expert consensus meeting, external expert reviewSystematic literature reviewLevels 1–4‡A–C, GPP‡
Khadilkar et al 37 Ottawa Panel Evidence-Based Clinical Practice Guidelines for Post-stroke Rehabilitation2006Physiotherapists, occupational therapists, physicians and clientsMultidisciplinaryExternal expert review and practitioner reviewSystematic literature reviewLevels 1–3.2‡A–D‡
RNAO29 30 (1) Nursing Best Practice Guideline. Stroke Assessment across the Continuum of Care2005Nurses, healthcare professionals and administratorsNursingExternal stakeholder review (including clients and families) SCORE Project reviewSystematic literature reviewLevels 1–4‡A–B, GPP‡
(2) Stroke Assessment across the Continuum of Care 2011 supplement2011Nurses, healthcare professionals and administratorsNursingPeer reviewSystematic literature review of published guidelinesLevels 1–4‡E‡
Europe
ESO38 39 Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack2008NSMultidisciplinaryNSSystematic literature reviewLevels 1–4‡A–C, GPP‡
Evidence-Based Stroke Rehabilitation: an expanded guidance document from the ESO Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008*2009NSMultidisciplinaryEditorial group reviewSystematic literature reviewLevels 1–4‡E‡
ISWP11 National Clinical Guidelines for Stroke2012Funders, clinical staff, managers of stroke services, patients with stroke, their families and friendsMultidisciplinaryInternal and external peer review (national and international)Systematic literature reviewLevels 1–3‡E‡
NICE18 Stroke Rehabilitation: long-term rehabilitation after stroke2013Healthcare professionals, educationalists, consumersMultidisciplinaryPublic consultationSystematic literature reviewLevels 1–3.2‡E‡
SIGN2 Brain Injury Rehabilitation in Adults2013Managers of a health service, healthcare clinicians, clients, their carers and researchersMultidisciplinaryNational open meeting, independently expert review, SIGN editorial groupSystematic literature reviewLevels 1–4A–D, GPP
SIGN33 Management of Patients with Stroke: identification and management of dysphagia (CPG 119)2010Healthcare clinicians, healthcare service planners, clients, their families and carersMultidisciplinaryConsumer review, independent expert review, public consultation, SIGN editorial group.Systematic literature reviewLevels 1–4A–D, GPP
SIGN10 Management of Patients with Stroke: rehabilitation, prevention and management of complications, and discharge planning (CPG 118)2010Health practitioners, specialists in public health, healthcare service planners, clients, families and carersMultidisciplinaryExternal expert review, public consultation, SIGN editorial group.Systematic literature reviewLevels 1–4A–D, GPP
  • *Level of evidence:

  • Level 1: A systematic review; meta-analyses of RCTs; well-powered RCTs.

  • Level 2: An RCT.

  • Level 3–1: A pseudo-RCT, that is, alternate allocation.

  • Level 3–2: A comparative study with concurrent controls: non-randomised experimental trial, cohort study, case–control study, interrupted time series with a control group.

  • Level 3–3: A comparative study without concurrent controls: historical control study, two or more single-arm studies, interrupted time series without a parallel control group.

  • Level 4: Case studies; a cross-sectional study or case series.

  • †Grade of the recommendation:

  • Grade A: Body of evidence can be trusted to guide practice (level 1 or 2 studies with low risk of bias).

  • Grade B: Body of evidence can be trusted to guide practice in most situations (level 1 or 2 studies with low risk of bias, level 1 or 2 studies with moderate risk of bias).

  • Grade C: Body of evidence provides some support for recommendation(s) but care should be taken in its application (level 3 studies with low risk of bias, level 1 or 2 studies with moderate risk of bias).

  • Grade D: Body of evidence is weak and recommendation must be applied with caution (level 4 studies or level 1–3 studies with high risk of bias).

  • Grade I: Insufficient information to formulate a recommendation.

  • Grade E: Nil grade system used, alternative approach based on evidence strength and consensus of the guideline development group.

  • ‡Level of evidence and/or grading system converted to NHMRC (2008) classification of evidence.

  • ABIKUS, Acquired Brain Injury Knowledge Uptake Strategy; CPG, clinical practice guideline; CSS, Canadian Stroke Strategy; DVA/DoD AHA, Department of Veterans Affairs/Department of Defence American Heart Association; ESO, European Stroke Organisation; Grade GPP, Good practice points based on clinical experience/consensus of the guideline development group; INCOG, international cognitive; ISWP, Intercollegiate Stroke Working Party; NHMRC, National Health and Medical Research Council; NICE, National Institute for Health and Care Excellence; NS, none stated; NZGG, New Zealand Guideline Group; RCT, randomised controlled trial; RNAO, Registered Nurses’ Association of Ontario; SCORE, Stroke Canada Optimisation of Rehabilitation by Evidence; SFNZ and NZGG, Stroke Foundation of New Zealand and New Zealand Guideline Group; SIGN, Scottish Intercollegiate Guidelines Network; TBI, traumatic brain injury.