{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:01:02Z","timestamp":1790427662541,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical practice guidelines (CPGs) are intended to support evidence\u2010based clinical decision\u2010making. However, the extent to which physical therapists' clinical decisions align with guideline recommendations remains uncertain, particularly in Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the alignment of Brazilian physical therapists' clinical decisions with recommendations from CTS clinical practice guidelines and to examine whether general evidence\u2010based practice (EBP) knowledge, self\u2010reported guideline use, and condition\u2010specific guideline knowledge are associated with this alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional study was conducted using an online questionnaire comprising two clinical vignettes representing mild and moderate CTS. Participants selected assessment and treatment strategies, which were scored using a weighted guideline\u2010alignment system based on the strength of the supporting evidence. Scores were expressed as percentages. Between\u2010group comparisons were performed using Welch's independent\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, and effect sizes were estimated using Cohen's d.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 282 physical therapists were included. Overall alignment with guideline recommendations was low (mean 46.2%, SD 10.7), with similarly low scores for assessment (45.9%\u2009\u00b1\u200914.5) and intervention (46.5%\u2009\u00b1\u200911.7). No significant associations were observed between guideline alignment and any of the investigated variables (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Effect sizes were uniformly small. All participants selected at least one non\u2010recommended intervention, and 66.7% selected at least one non\u2010recommended assessment procedure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinical decisions made by Brazilian physical therapists showed limited alignment with CTS clinical practice guideline recommendations. General EBP knowledge, self\u2010reported guideline use, and condition\u2010specific guideline knowledge were not significantly associated with guideline alignment, and all observed effect sizes were small. These findings suggest that improving guideline implementation requires addressing factors beyond individual knowledge and highlight the importance of behavioural, organizational, and contextual determinants of clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70575","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:50:57Z","timestamp":1788162657000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Decision\u2010Making and Guideline Alignment Among Brazilian Physical Therapists: Evidence From Standardized Carpal Tunnel Syndrome Vignettes"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9627-0870","authenticated-orcid":false,"given":"Luciane Fernanda Rodrigues Martinho","family":"Fernandes","sequence":"first","affiliation":[{"name":"Department of Applied Physiotherapy Universidade Federal do Tri\u00e2ngulo Mineiro Uberaba Minas Gerais Brazil"},{"name":"Graduate Program in Physical Education, Universidade Federal do Tri\u00e2ngulo Mineiro Uberaba Minas Gerais Brazil"},{"name":"Graduate Program in Physiotherapy Universidade Federal do Tri\u00e2ngulo Mineiro and Universidade Federal de Uberl\u00e2ndia, Uberaba and Uberl\u00e2ndia Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda Tha\u00eds Alves","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Graduate Program in Physical Education, Universidade Federal do Tri\u00e2ngulo Mineiro Uberaba Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-8966","authenticated-orcid":false,"given":"Darlisson Bueno","family":"Paranhos","sequence":"additional","affiliation":[{"name":"Graduate Program in Physical Education, Universidade Federal do Tri\u00e2ngulo Mineiro Uberaba Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2720-3287","authenticated-orcid":false,"given":"V\u00edtor Hugo Mendes","family":"Castro","sequence":"additional","affiliation":[{"name":"Graduate Program in Physiotherapy Universidade Federal do Tri\u00e2ngulo Mineiro and Universidade Federal de Uberl\u00e2ndia, Uberaba and Uberl\u00e2ndia Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda Avelar de","family":"Resende","sequence":"additional","affiliation":[{"name":"Graduate Program in Physiotherapy Universidade Federal do Tri\u00e2ngulo Mineiro and Universidade Federal de Uberl\u00e2ndia, Uberaba and Uberl\u00e2ndia Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Regina Mendes da Silva","family":"Serr\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy Universidade Federal de S\u00e3o Carlos, S\u00e3o Carlos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2026.0301"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-24-01179"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199609000-00002"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01140-0"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/02692155221141036"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.14218"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04250-4"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-024-05630-4"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14061889"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jht.2019.03.003"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18041995"},{"key":"e_1_2_17_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jht.2025.07.001"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.13532"},{"key":"e_1_2_17_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-011-9305-5"},{"key":"e_1_2_17_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2006.00699.x"},{"key":"e_1_2_17_17_1","doi-asserted-by":"crossref","DOI":"10.1590\/1809-2950\/e23006724pt","article-title":"Perfil demogr\u00e1fico e Profissional Dos Fisioterapeutas Traumato\u2010Ortop\u00e9dicos Brasileiros","volume":"31","author":"Resende A. 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