Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy. AACPDM Treatment Outcomes Committee Review Panel.

The objective of this and other systematic reviews by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) is to provide the biomedical research and clinical practice communities with current knowledge about evidence supporting various interventions used in the management of developmental disabilities. "Systematic, evidencebased reviews are innovative in their comprehensive review of the literature, use of standard methods of presenting data, and special emphasis on the validity of research methods." (p.470)1 AACPDM reviews summarize what is known and not yet known, to identify the gaps in our information about treatment outcomes and to gauge the strength of the internal validity of that evidencea. AACPDM reviews are not to be construed as practice guidelines, nor do they indicate the extent to which available evidence may be applicable to other people. Until comprehensive and robust bodies of evidence, necessary to determine generalizability of research findings, do become available, clinicians must rely on ‘best evidence’ to guide their treatment recommendationsb. Clinical relevance of the outcomes, including benefits or risk judgments, must also be determined by the individual clinician from the data, often limited, in the evidence tables. Unfortunately, whether a difference between groups is clinically important is frequently difficult to ascertain, as there is no clear and standard criteria for deciding or because authors do not address the issue.