How to Use and Understand the Guidelines
Icons used in these guidelines
Recommendations with are strongly recommended; the symbol indicates clinicians’ top recommendations; or indicates that reviewed publications pertain to the guideline background; blue indicates a subtype that increases the strength of the recommendation.
Types of Knowledge
The guideline recommendations are based on four different types of knowledge: empirical knowledge; knowledge about the health care ecosystem; clinical expert knowledge; and experiential knowledge. The subtypes of knowledge are related to the strength of recommendation.
Learn more about types and subtypes of knowledge
Strength of Recommendation
These guidelines outline standards of care for which there is a good basis in current knowledge. Other factors, however, were considered for deciding whether a proposed action is “strongly recommended” or “recommended”, including availability and use of resources.
Learn more about strengths of recommendations
Reflect on these guidelines and earn Mainpro+ credits!
Learn how to earn Mainpro+ credits
The Developmental Disabilities Primary Care Program is supported and funded by the Ontario Ministry of Health and Long-Term Care, Ontario Ministry of Children, Community and Social Services and Surrey Place, Toronto.
These recommendations were selected by 5 clinicians (family physicians and a psychiatrist) as the most important to promote in any clinical practice or recommendations that pertain to health issues that are most commonly overlooked in patients with IDD
A strong recommendation is one that can be supported without qualification by family physicians and other health professionals providing primary care. They can be confident that all the following conditions apply:
- There are at least 3 types of knowledge supporting a recommendation or at least 2, one of which is in a category subtype indicated by a blue circle or . This condition is taken to be an indication of the breadth, depth and special relevance of knowledge.
- There is a greater balance of anticipated medical benefit or positive clinical impact over risk of harm;
- Most people with IDD and their caregivers would find the intervention to be tolerable;
- The family physician or other primary care provider would typically have the resources (eg, time, materials, training, supports) to engage in the approach or offer the intervention, or would be able to accommodate or advocate for the approach or intervention.
- The approach or intervention is an effective use of resources, taking into consideration factors such as the impact on the time, priorities and out-of-pocket expenses of patients and their caregivers and the limits of the practice or health care system.
These actions have a good basis in current knowledge. Family physicians and other health professionals providing primary care will need more extensive discussion than usual, however, with patients with IDD and caregivers and/or consultation with other health professionals, ethicists or health care administrators before deciding to implement the guideline.[/ultimate_modal][ultimate_modal modal_title=”Types of Knowledge” modal_on=”custom-selector” modal_on_selector=”.knowledge-help-lp” modal_size=”medium” overlay_bg_opacity=”80″ img_size=”25″ close_icon_position=”popup-top-right”]Blue and grey circles indicate different category subtypes. Half circles or indicate that the studies pertain to the background for the guideline. In each category, only the top ranking is shown and in the following priority of highest to lowest: . Tools and other practical resources are not categorized.
experimental studies (eg, RCT) and systematic review or meta-analysis of such studies;
observational studies (eg, case report, case-control, cross-sectional or cohort/longitudinal studies) or systematic review and meta-analysis of such studies.
through an explicit consensus process (eg, systematic review, synthesis of knowledge, consultation or discussion);
without an explicit consensus process.
patients with IDD or caregivers;