Designed in a question and answer format, the Knowledge Pathway represents a collection of Practice Questions, evidence-based answers, references, Practice Guidance Toolkits, Summaries of Recommendations and Evidence, Backgrounds, Tools and Resources, and other related materials on a particular topic.
Knowledge Pathways are organized into four practice categories: Population Heath/Lifecycle, Health Condition/Disease, Food Nutrients, Professional Practice.
Generally formulated using the PICO approach (Population, Intervention, Comparison, Outcome), Practice Questions reflect the everyday practice situations faced by dietitians.
Practice Question Subcategories
To filter and find a relevant question, practice questions are organized by subcategories: Assessment, Diagnosis, Intervention, Monitoring, Evaluation (ADIME) and Other. Links are also provided to related Practice Questions from other Knowledge Pathways.
Key Practice Point
Based on a synthesis of the most valid, important and applicable evidence, the Key Practice Points provide a succinct evidence-based recommendation or “answer” to a dietetics practice question. Key Practice Points include three subcategories: Recommendations, Evidence Summary and Remarks. Supporting information is in provided in Evidence (Statements), Comments/ Rationale and References.
Recommendations are clear, concise and actionable advice on whether to implement an intervention and, if relevant, under what conditions and how.
For GRADE questions only, recommendations include:
the strength of the recommendation, i.e. “Strong” or “Conditional” and the overall quality of evidence and its corresponding symbol, i.e. “Very Low” ⊕⊝⊝⊝, “Low” ⊕⊕⊝⊝, “Moderate” ⊕⊕⊕⊝, “High”. ⊕⊕⊕⊕
A succinct summary and critical appraisal of each article used to answer the practice question. Evidence summaries are graded (A, B, C or D) based on the strength of the evidence used to support them. Supporting research and/or evidence is provided in the Evidence Statements.
Remarks describe the justification for the recommendation and present information that would be most useful and relevant to consider in discussion with a client, including author defined terms and additional PEN content.
A summary of the critically appraised evidence for each referenced article including type of study, the population studied, number of subjects, methods used, main findings and study limitations.
Includes relevant information to support the Key Practice Point that does not belong in the evidence statements (e.g., food sources of a vitamin, comment on length of trial, social context) that is useful for the acceptability, applicability, and feasibility in the practice context.
Allows an explanation of the proposed or known mechanisms of action, reasoning behind the research hypotheses and explanation for theories for the course of action or change.
References are hyperlinked to PubMed abstracts, if applicable, or to full articles or practice guidelines, if the PubMed link is not available.