Table 3.
Guideline* | Strength of Recommendation and Evidence Ratings‡ by Antipsychotic Measure Concept
|
|||||||
---|---|---|---|---|---|---|---|---|
Use in Very Young Children | Multiple Concurrent Antipsychotics | Higher Than Recommended Doses | Use Without a Primary Indication | Access to Psychosocial Interventions | Metabolic Screening | Follow-up Visit With Prescriber | ||
AACAP-AAA | Strong | Strong | Moderate | Strong | Strong | Strong | Strong | |
AACAP-PsyMed | Unrated | Unrated | ||||||
AACAP-BP | Strong | Strong | Strong | |||||
AACAP-ODD | Moderate | Strong | ||||||
AACAP-SZ | Strong | Strong | Strong | Strong | ||||
CAMESA† | Strong (SOR)‡, high (SOE)‡ | |||||||
PPWG§ | Strong–weak† | Strong–weak† | Strong–weak† | Unrated | Unrated | |||
TRAAY | Unrated | Unrated | Unrated | Unrated | ||||
T-MAY | Strong (SOR), weak (SOE) | Unrated | Unrated | Strong (SOR), high (SOE) | Strong (SOR), high (SOE) | |||
TX | Unrated | Unrated | Unrated | Unrated | Unrated | Unrated | ||
APA-CW | Unrated | |||||||
Totals | ||||||||
CPG with recommendation | 3 | 4 | 5 | 7 | 7 | 8 | 6 | |
CPG with rated recommendation | 2 | 2 | 2 | 3 | 6 | 5 | 3 | |
CPGs with | 2 | 2 | 1 | 2 | 6 | 5 | 3 | |
SOR = strong | ||||||||
CPGs with | 0 | 0 | 0 | 0 | 1 | 2 | 0 | |
SOE = strong |
CPG indicates clinical practice guidelines; SOR, strength of recommendation; and SOE, strength of evidence.
See Table 1 for full names.
CAMESA provides ratings of both SOR and SOE and rate each antipsychotic medication, each time interval (0, 3, 6, 12 months) and each test separately. All combinations cannot be shown, but in general, testing is strongly recommended, and evidence is rated highest at 0 and 3 months.
CPG ratings were categorized as strong/high, moderate, or weak to facilitate comparisons across guidelines (see Table 2). Most guideline rating systems did not rate strength of recommendation and evidence separately. To be conservative, we consider all ratings as SOR unless it is specified that the rating is for SOE.
PPWG provides ratings for each step of treatment algorithms for 9 different diagnoses. All combinations cannot be represented; variation exists in ratings by diagnosis and age.