NEDA TOOLKIT for Parents
The Evidence on What Treatment Works:
Clinical Guidelines and Evidence Reports
If you want access to the same documents that clinicians use to guide their treatment decisions, and if you want to
know what the available evidence says on what works for treatment of eating disorders, you want to look at
published clinical practice guidelines and medical journal articles called systematic reviews. The information in
this document provides links to that information so you can look it over and take it with you to discuss the care
plan with the physicians and others who will treat your family member.
This document discusses two types of evidence-based
information used by clinicians in determining
appropriate care for eating disorders: clinical practice
guidelines and systematic reviews. We define below
what an evidence-based clinical guideline and a
systematic review are and provide links to the
documents. If you review this information before
meeting with the care team, it can help you have
informed discussions about care plans with your loved
one’s care team.
Systematic Reviews of Clinical Studies
A systematic review is a comprehensive review and
analysis of data from the available published clinical
studies on existing methods of diagnosing and treating
a disorder. Researchers start out with key clinical
questions that they seek to answer, and then they
perform a comprehensive search for published data to
analyze to address the questions. Thus, the data for
analysis are collected from as many published clinical
studies as there are to address the question. The data
are then pooled together statistically where possible
and analyzed to figure out how well each treatment
works and for whom it works best. Sometimes sufficient
data are not available to conclusively answer a
question. Knowing where the holes in the research are
is important, because that knowledge will help in
planning new research that hopefully will answer the
questions about “what works?” Also, it’s important to
understand that some treatments may not have
evidence available about how well they work.
Therefore, your decisions about treatment may have to
be based on considerations other than conclusive
clinical evidence. A lot more research is needed about
what works best in the field of eating disorders. That
said, some information is available about how well
some types of treatment work. Keep in mind that a lack
of evidence doesn’t mean that a treatment does not
work—it just means no evidence is available to be able
to conclude whether or not it works.
Following this section are links to two systematic
reviews: one pertains to bulimia nervosa and pooled
data together where possible on all the different
treatments for bulimia eating disorders in general; the
other systematic review did not pool data for analysis
from groups of studies, but rather looked at individual
studies on their own. Both systematic reviews were
performed by very reputable research organizations:
two U.S. Evidence-based Practice Centers of the U.S.
Agency for Healthcare Research and Quality (AHRQ).
Links to the Executive Summary and full Evidence
Reports are provided.
Bulimia Nervosa: Efficacy of Available
Treatments A Systematic Review conducted by ECRI Institute
Evidence-based Practice Center ECRI Institute’s
approach was unique in producing this evidence report
and the bulimia nervosa resource guide. The focus of
the work was driven by an external advisory committee
of patients and family members affected by bulimia
nervosa, clinicians and specialists from leading eating
disorder treatment centers that treat eating disorders,
scientists who conduct research on eating disorders,
health insurance representatives, and others who
affect patient care. ECRI Institute gratefully
acknowledges the support of The Hilda & Preston Davis
Foundation, which provided major funding for this
evidence report and the family resource guide and
Web site that emerged from the research. The
approach was unique because of the intensive
involvement of families and recovering patients in
formulating the key questions and reviewing the family
and patient information before publication.
Link to the Summary:
http://www.bulimiaguide.org/static/report_summary.p df
Link to the Full Report:
http://www.bulimiaguide.org/static/report_complete.p df
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