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AMERICAN COLLEGE OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINEACOEM is the pre-eminent organization of physicians who champion the health and safety of workers, workplaces, and environments
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Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers, Second Edition 

METHODOLOGY

Enhanced Methodology Adopted for Updates to the Guidelines

 The enhanced methodology incorporates the highest scientific standards for reviewing evidence-based literature, thus ensuring the most rigorous, reproducible, and transparent occupational health guidelines available. Under the new methodology, the process begins with the identification of high-quality original research studies on a topic, as well as high- and intermediate-quality systematic reviews and meta-analyses relevant to each topic. Only evidence with the highest available rating (e.g., randomized controlled trials) is selected for critical appraisal. Each article that meets the inclusion criteria is reviewed, critically appraised, and abstracted into evidence tables that include details of study methods, outcomes, and statistical analyses. Panels of experts review the articles and evidence tables and agree on the strength-of-the-evidence ratings (A, B, C, or I). Panels then draft recommendations with citation of references for each recommendation. “First principles”, health benefits, side effects, and risks are explicitly considered and discussed in formulating recommendations. Recommendations are made under the following categories: strongly recommended (A), moderately recommended (B), recommended (C), insufficient-recommended (I), insufficient-no recommendation (I), insufficient not-recommended (I), recommended against (C), moderately recommended against (B), strongly recommended against (A).

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