A Delphi consensus-based guideline for the implementation of therapeutic carbohydrate reduction in metabolic disorders.
We are excited to present a peer-reviewed and published consensus-based guideline on theimplementation of therapeutic carbohydrate reduction (TCR) in metabolic disorders.
This document replaces the implementation document first published in 2019 and was subject to a more structured framework in its development.
This consensus-based guideline followed a modified Delphi consensus methodology, which is a structured and validated approach used to systematically develop agreement among experts through iterative rounds of anonymous feedback and surveys in order to achieve a consensus-based recommendation. The Delphi method is widely accepted for consensus development in healthcare, including the creation of clinical guidelines and also for complex or under-investigated clinical issues and definitions and to inform best practices where high-quality evidence is lacking.
This process involves the oversight of a steering committee (article authors), who oversee the document development, and a Delphi panel, who provide feedback. Several rounds of iteration are followed by an anonymous survey whereby the degree of consensus is measured.
Authors/Steering committee:
Sarah M. Rice, BSc. (Hons), MCOptom (UK), MHP; Laura A. Buchanan, MD, MHP; Matthew W. Calkins, MD, MHP; Mark T. Cucuzzella, MD, MHP, Professor of Medicine; Robert Cywes, MD, PhD; Pamela L. Devine, MHP; Miriam Kalamian, EdM, MS, CNS; Tro Kalayjian, DO; Douglas B. Reynolds, BSc (Elec Eng), MHP; Eric C. Westman, MD, Associate Professor of Medicine
Delphi Panel:
Nadir Ali, MD; Amy Berger, CNS; Lori Calabrese, MD, MHP; Dr. David Cavan, MD, FRCP; Dr. Gary Fettke, M.B.,B.S., F.R.A.C.S.(Orthopaedic Surgery), F.A.Orth.A.; Tony Hampton, MD, MBA, ABOM, CPE, MSHNFM; Lily E. Johnston, MD, MPH, MHP; Brian Lenzkes, MD, MHP; Barbara Levy, MD; Prof Tim Noakes; Caroline G.P. Roberts, MD; Roshani Sanghani, MD, MHP; Bret Scher, MD; Franziska Spritzler, RD, CDCES; Dr. David Unwin, FRCGP; William S. Yancy, Jr., MD, MHS
Acknowledgement:
The steering committee acknowledges the late Adele Hite, PhD, MPH, RD, who coordinated and synthesised expert input for the first implementation guideline document published on the website in 2019.
Patient safety and support is of the highest importance. For practitioners who do not have prescribing/de-prescribing privileges, this means ensuring that all patients using therapeutic carbohydrate reduction are assisted in adjusting medications as needed by a professional trained in this process.
Useful Links
In addition, the SMHP has compiled a companion series which summarises evidence for TCR being investigated in emerging clinical areas.
The following topics are currently available:
- Neurology
- Psychiatry
- Oncology
- Food addiction