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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 Page | 30