The influence of standards and clinical guidelines on prosthetic and orthotic service quality: a scoping review

Abstract

Studies tended to be commentaries on or descriptions of guideline development, testing or implementation of standards. The literature is not sufficiently well developed to warrant the cost and effort of a systematic review. Future primary research should seek to demonstrate whether and how guidelines and standards improve the outcomes for people that require prostheses, orthoses and other assistive devices. Implications for Rehabilitation International Standards and Clinical Guidelines are now an integral part of clinical service provision in prosthetics and orthotics in the developed world. Complying with standards and guidelines has a cost and, particularly in resource-limited environments, it should be possible to justify this in terms of the resulting benefits. This scoping review concludes that there have been no previous studies designed to directly quantify the effects of implementing standards and guidelines on service delivery.

The necessity of using high quality orthoses in rehabilitation medicine

“…Although some present scientific studies do not provide sufficient arguments in order to draw strong conclusions on effectiveness and cost-effectiveness of orthotic devices [8], we sustain the importance of using high quality orthoses in rehabilitation medicine. There are many researches that point out the utility of orthotic intervention in scoliosis, knee deformities and rheumatoid arthritis [9][10][11][12].…”

Customized Three-Dimensional-Printed Orthopedic Close Contact Casts for the Treatment of Stable Ankle Fractures: Finite Element Analysis and a Pilot Study

“…The 3D bone geometric model was created and smoothed using Geomagic Studio software (version 12, Raindrop Geomagic, NC), and a stable Weber-B1 fibular fracture was stimulated as a 4 mm transverse fracture gap above the lateral malleolus with the surface cutting function (Figure ). Considering the manufacturing guideline instructions and cooperation with orthopedic surgeons, the curve command in the software was used to draw the trimming line on the geometric soft tissue model.…”

“…Considering the manufacturing guideline instructions 32 and cooperation with orthopedic surgeons, the curve command in the software was used to draw the trimming line on the geometric soft tissue model.…”

Obstacles to Prosthetic Care—Legal and Ethical Aspects of Access to Upper and Lower Limb Prosthetics in Germany and the Improvement of Prosthetic Care from a Social Perspective

“…[55][56]. CPGs tend to be rather heterogeneous guideline documents [47], which may be produced by (national) medical associations and health organisations or departments [45,46,48], but also othe players in the health care system such as hospitals [43,49] and insurance companies [44]. In any case, they are not binding for care providers however.…”

“…The NHS (National Health Service of England) proposes that with a standardised practice related outcome evaluation (of orthotics) one could develop practical guidelines that could improve quality of care and save money [70]. The impact of prosthetic guideline implementation has to be evaluated in order to prove such claims [47]. Reimbursement decision (bodies) (in Germany G-BA and GKV), practical guideline developers (clinicians and prosthetists) and HTA assessment bodies are however separated [50] (p. 5).…”