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Knowledge Pathway
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.
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Practice Category
Knowledge Pathways are organized into four practice categories: Population Heath/Lifecycle, Health Condition/Disease, Food Nutrients, Professional Practice.
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Practice Question
Generally formulated using the PICO approach (Population, Intervention, Comparison, Outcome), Practice Questions reflect the everyday practice situations faced by dietitians.
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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.
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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 provided in Evidence (Statements), Comments/ Rationale and References.
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Recommendations
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”. ⊕⊕⊕⊕
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Evidence Summary
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.
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Remarks
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.
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Evidence
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.
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Comments
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.
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Rationale
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.
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References
References are hyperlinked to PubMed abstracts, if applicable, or to full articles or practice guidelines, if the PubMed link is not available.