The N-CEP Compendium of Clinical Practice Guidelines and Systematic Reviews

In the summer of 2005, staff of ASHA's National Center for Evidence-Based Practice in Communication Disorders (N-CEP) embarked upon a project to identify and obtain clinical practice guidelines from all over the world related to audiology and/or speech-language pathology. As noted elsewhere on this site, clinical practice guidelines, when tied directly to a systematic review of scientific evidence, can be an invaluable tool in helping clinicians to make the best decisions with and for their clients. These guidelines and reviews are presented for informational purposes only, and their inclusion does not imply ASHA endorsement of or agreement with any particular conclusions or recommendations.

Unfortunately, many guidelines are developed with questionable methodological rigor, and/or reflect the bias(es) of the authors. In order to address these shortcomings the European Union in the 1990s sponsored the development of what came to be known as the Appraisal of Guidelines for Research and Evaluation II, or AGREE II, Framework. This Framework, which has been adopted in most European and North American countries, consists of 23 criteria across six domains, such as rigor of development, stakeholder involvement, etc. The criteria are then scored, giving a total for the guideline. Depending upon the total score, guidelines are categorized as Highly Recommended, Recommended with Provisos, or Not Recommended. N-CEP staff have reviewed and scored each guideline. Only those guidelines with an overall rating of Highly Recommended or Recommended with Provisos are included in this compendium. Most of the more than 200 guidelines reviewed in the summer and fall of 2005 fell short of this mark.

Also included in this compendium are a limited number of systematic reviews. These reviews can be an important and time-saving resource for clinicians wishing to incorporate evidence into their clinical decision making. Each review included in the compendium has been evaluated by N-CEP staff according to some basic quality indicators. However, at present the compendium should not be viewed as exhaustive nor should inclusion of a review on the list be considered an endorsement. Readers are encouraged to consult the complete text of a systematic review to determine its validity and relevance to their clinical question. 

New guidelines and systematic reviews are published every day, and we will endeavor to keep this compendium as current as possible. We anticipate that the compendium will be updated on a monthly basis. We hope that you find this a useful tool, and would appreciate your feedback on how we can make it better. If you have any suggestions or if there is a guideline or systematic review you would like to see included on the compendium, please contact us at

Rob Mullen
Director, N-CEP

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