1. ACOEM Council on Education and Academic Affairs
Guidance on Preparation of Evidence-Based Presentations and Educational Materials
ACOEM Council on Education and Academic Affairs

2. ACOEM Educational Guidance
The ACOEM Council on Education and Academic Affairs advocates the creation of clinical and scientific educational content based on the best available evidence
Goal is the best functional outcomes for workers/patients
Materials, presentations and programs should be clear and transparent about the justification for statements and recommendations
Learners should be able to make informed decisions about implementing the recommendations in their practices

3. Evidence-Based Medicine (EBM):
“… is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.
…means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”
Sackett DL, et al. BMJ. 1996;312:71-80.

4. The Evidence-Based Approach Uses
An objective, graded assessment of the entire body of high quality literature on that topic
It is NOT:
Selecting an article to support a viewpoint
Selecting a few articles for support
Reprinting abstracts without critical appraisal

5. Why Does EBM Matter?
Increases audience confidence in the value, objectivity, effectiveness and reproducibility of the tests or procedures
Increases transparency
Provides a balanced approach
Protects patients from ineffective or risky care
Increases cost-effectiveness and value

6. ACOEM First Principles provide a framework for integrating EBM into patient care
Ethics
Disclose financial, intellectual conflicts of interest
Comport with ACOEM Code of Ethics
Use evidence based testing and treatment when possible
Testing
Treatment
Invasive treatment
Choose the most cost effective of equivalent options
Manage to an agreed-on treatment plan
Emphasize functional improvement
Shared decision making

7. Aspects of Occupational Health Care for Which Evidence Should be Reviewed
Clinical or diagnostic testing and diagnosis
Occupational risk factor determination
Exposures
Prevention
Evidence basis for (preventive) regulations
Treatment
Disability management/return to work
Impairment

8. Additional Issues for which Supporting Evidence is Important
Accuracy of symptoms, signs
Prevalence
Etiology prognosis
Clinical assessment (diagnosis/testing)
Treatment
Harms
Cost-effectiveness
Disability management
Quality of life

9. Transparency to the audience is key
We Encourage Educational Content on the Full Range of Topics Relevant to our Profession
ACOEM EBM Guidance is NOT intended to discourage presentation of issues for which there is limited/no evidence basis
Discussion of “clinical judgment” and clinical topics for which evidence basis is incomplete is OK when disclosed as such
Transparency to the audience is key

10. Suggestions for Preparation of Presentations and Materials

11. Types of Evidence to Use in Presentations
Evidence-based (EB)
High quality clinical practice guidelines
Quality systematic reviews and meta-analyses
De novo literature search, appraisal and synthesis
Evidence informed – above without critical appraisal
Listing of literature – annotated descriptive bibliography
Professional consensus
Experience and/or opinion
Regulatory guidance – ideally citing scientific bases for regulations

12. Evidence Informed Approach
Assemble studies you have found on topic of clinical/scientific importance
Critically appraise key studies - strengths and weaknesses
Consensus recommendations
Use in cases of insufficient quality evidence
Individual recommendations
If consensus not obtained

13. Practical Guidance for Speakers
Clearly inform the audience of the evidence basis (EB) for your presentation as practicable
Approach may be adapted to type of presentation
Impractical to discuss EB detail for each item in a broad review
A summary statement at beginning may suffice in some cases
Discuss type of evidence analyses to support your recommendations whenever possible
Done by others (meta-analyses, systematic reviews, etc.)
Your own critical appraisal of recent literature
Cite type, consistency, strength and quality of studies

14. Provide Listing of Literature with Annotated Bibliography
List the references you relied on in standard reference format
Ideally, attach a short paragraph describing:
The type of study (controlled trial, cohort, case-control, case series, etc.)
The objectives of the study
Key findings
Optional comments on the robustness of the study design and execution, short of a critical appraisal

15. Practical Guidance for Speakers
It is not necessary to review evidence for legal, regulatory, or commonly used consensus documents (e.g., AMA disability guidelines) unless that is the main purpose of the presentation
Be cautious (and transparent) when making clinical recommendations based on limited evidence

16. Thank you for your consideration!