PelvicEx clinical-review policy

Short answer

The purpose of clinical review is to test whether health content is accurate, appropriately cautious, relevant to the intended population, and safe within a self-guided website. The required reviewer depends on the topic. A pelvic-health physiotherapist may be well suited to contraction technique, while postoperative, pregnancy, bowel, sexual-health, oncology, neurological, or urgent-care content may need a different or additional specialist.

PelvicEx keeps versioned quality-control records for health content. Evidence lists, automated checks, and AI-assisted fact checking can support that process, but they do not establish clinical accuracy or individual suitability on their own.

What clinical review is—and is not

Clinical review is a structured critique of public-facing content. It checks claims, scope, risk, wording, sources, and proposed user actions. The reviewer can approve the page, require revisions, or reject it for the proposed use.

Clinical review is not:

an examination of the reader;
a diagnosis or treatment relationship;
proof that the exercise is suitable for every person;
regulatory clearance of PelvicEx as a medical device;
a guarantee that evidence will never change;
a substitute for editorial, copyright, localization, accessibility, security, or software testing;
an endorsement of advertisements or products near the article.

A clinician reviewing one guide does not automatically approve the entire website, trainer, programme catalogue, or future revisions.

Who owns the decision

The PelvicEx project owner retains the publication decision and must ensure that the right expertise is requested, revisions are completed, conflicts are considered, and internal records match the work completed. A reviewer owns their clinical opinion but does not become responsible for product operations outside the reviewed scope.

Internal review records should identify:

the reviewer’s name and relevant professional credentials;
jurisdiction or credentialing body where appropriate;
subject expertise relevant to the page;
exact English and/or Thai version reviewed;
review date and evidence cut-off date;
scope of review and any conditions;
disclosed financial and non-financial relationships;
final outcome and required follow-up date.

Review records are kept internally and tied to the relevant content version. Public pages focus on sources, scope, safety boundaries, and update dates.

Matching review to content risk

Review requirements reflect the topic’s risk and the expertise needed, rather than search popularity or writing difficulty.

Definitions and product guidance

These pages cover definitions, navigation, general product information, and policy. AI assistance may be used, but a human editorial and source check is still required. If a page includes a clinically significant claim, that claim still needs appropriate evidence and can be escalated for professional review.

Clinical evidence and programme design

These pages summarize treatment evidence, explain clinically meaningful distinctions, or describe general programme design. A suitably qualified health professional should review the claims, boundaries, and practical implications before PelvicEx presents the page as professionally reviewed.

Safety-sensitive topics

Safety-sensitive pages address areas where incorrect or overly generic advice could contribute to harm or delay care. Examples include pelvic pain, inability to relax, postoperative or catheter timing, pregnancy and postpartum complications, prolapse symptoms, urinary retention, bowel-emptying dysfunction, cancer treatment, erectile or ejaculatory concerns, and urgent neurological signs.

These pages need a reviewer whose current practice or scholarship matches the subject. A general health credential alone may not be enough.

Matching expertise to the topic

Reviewer selection is based on the claims being made. Depending on scope, the review team may include:

a pelvic-health physiotherapist or physical therapist for muscle assessment, motor control, exercise technique, progression, relaxation, and rehabilitation;
a urologist, continence specialist, or appropriately experienced pelvic-health clinician for urinary symptoms, retention, prostate treatment, and relevant male pelvic health;
an obstetrician–gynecologist, urogynecologist, midwife within their scope, or perinatal pelvic-health physiotherapist for pregnancy, birth recovery, prolapse, and gynecologic concerns;
a colorectal surgeon, gastroenterologist, continence clinician, or pelvic-health physiotherapist with bowel expertise for fecal incontinence, constipation, and defecatory coordination;
a sexual-medicine clinician or appropriately qualified pelvic-health or psychosexual professional for erectile, ejaculatory, painful-sex, and sexual-function content;
an oncology rehabilitation professional or treating oncology team member for pelvic cancer surgery, radiotherapy, and treatment restrictions;
a neurologist, spinal specialist, emergency clinician, urologist, or other relevant professional for neurological red flags and urgent bladder or bowel loss.

More than one reviewer may be necessary when a page crosses disciplines. PelvicEx should not ask a reviewer to approve claims outside their competence.

What the reviewer checks

The clinical review form should require an explicit answer for each area below.

Evidence and claims

Do cited sources support the exact definitions, populations, interventions, outcomes, and limitations stated?
Are systematic reviews, guidelines, terminology papers, and public guidance characterized correctly?
Are associations kept separate from causes and diagnoses?
Are benefits expressed without guarantees, inflated certainty, or unsupported numbers?
Is the evidence current enough for the topic, and are important conflicting findings acknowledged?

Technique and programme instructions

Does the page distinguish contraction, inward lift, full release, breathing, coordination, strength, endurance, and power where relevant?
Are dose, frequency, effort, position, progression, and recovery ranges supportable and suitable for a general audience?
Does the programme avoid treating age, sex, body size, or a symptom label as a reliable measure of muscle function?
Are clinician-taught plans and treatment-stage restrictions given priority over generic content?
Could a reader with pain or a non-relaxing pelvic floor reasonably misapply strengthening advice?

Safety and escalation

Are emergency signs separated from routine stop rules and non-urgent assessment advice?
Could the wording delay care for retention, neurological change, infection, bleeding, severe pain, postoperative complications, or cancer-treatment concerns?
Does the page state when to stop an exercise that causes pain or worsening symptoms?
Are limitations of self-report and app-based screening clear?
Does the page avoid implying that absence from a short red-flag list proves safety?

Population and language

Is the intended population named, and are exclusions or evidence gaps visible?
Are sex- or anatomy-specific findings not generalized beyond the source?
Is language respectful, understandable, and clinically unambiguous?
Does the Thai adaptation preserve the same claim strength, stop rules, urgency, and uncertainty?
Are translated technical terms likely to be understood by Thai readers and recognized by clinicians?

Review of both languages

Review is version- and language-specific. Reviewing English alone does not establish that a localized adaptation preserves meaning. Each language should be checked independently for clinical meaning, caution, terminology, and care routes, with discrepancies reconciled.

A language adaptation must not borrow authority from the source version. Public pages should present the same evidence boundaries and safety instructions without exposing internal workflow states.

Internal quality records

Internal records identify the content version, reviewer scope, evidence boundary, findings, required changes, and next review trigger.

the exact content and language reviewed;
the checks completed, limitations found, and changes requested; and
the reviewer identity, relevant credentials, conflicts, date, and follow-up trigger.

Content with unresolved material problems should not remain publicly presented as usable health guidance. Corrections must address the underlying problem rather than changing how the page is categorized.

Resolving comments and disagreements

Every substantive comment should have a recorded response: accepted, revised in another way with a reason, or escalated to another relevant reviewer. Editorial preference cannot overrule a safety objection without appropriate clinical resolution.

Reasonable professionals can interpret limited evidence differently. When disagreement remains, PelvicEx should narrow the claim, state the uncertainty, seek another relevant review, or omit the instruction. It should not average incompatible opinions into a confident recommendation.

Conflicts, independence, and confidentiality

Reviewers should disclose employment, consulting, payment, ownership, intellectual commitments, product involvement, or close relationships that could reasonably affect judgment. A relationship does not automatically invalidate expertise, but it must be evaluated and, when material, disclosed or handled by choosing another reviewer.

The ICMJE recommendations on review and conflicts emphasize independent critical assessment, confidentiality, constructive review, disclosure, and recusal when bias is possible. PelvicEx is not a medical journal and does not claim formal journal peer review, but these principles provide a useful minimum for accountable expert critique.

Advertisers, app-store partners, affiliates, and competitors cannot select reviewers, influence conclusions, see confidential drafts by default, or suppress an adverse finding.

When review needs repeating

A completed review applies to the exact content, evidence boundary, programme version, and language. Re-review is required when a material change affects:

a medical conclusion, benefit, harm, contraindication, red flag, or care route;
exercise dose, progression, recovery, or eligibility;
a population or treatment stage;
a cited source that is replaced, corrected, withdrawn, or contradicted;
the Thai meaning or safety emphasis;
app behaviour that the guide describes;
a shared component that changes clinical instructions or public guidance.

Spelling, layout, or non-substantive accessibility fixes normally do not require a full repeat review, but the change should still be checked to ensure meaning was not altered. A scheduled evidence review date does not replace immediate review when a serious concern emerges.

Public presentation

Content-risk levels guide internal quality-control effort. Public pages present the evidence, scope, safety boundaries, and update date without displaying internal workflow states.

Readers should use the medical disclaimer and product limitations to understand what the website cannot assess. Sources and quality controls never convert general education into personal medical advice.

Policy basis and sources

International Committee of Medical Journal Editors. Responsibilities in the Submission and Peer-Review Process and Disclosure of Relationships, Activities, and Conflicts of Interest. Official ICMJE recommendations.
Frawley HC, Shelly B, Morin M, et al. An International Continence Society report on pelvic-floor muscle assessment terminology. Neurourology and Urodynamics. 2021;40(5):1217–1260. PubMed record.
World Health Organization. Ethics and governance of artificial intelligence for health. 2021. Official WHO publication.
Reviewer matching, versioned records, language-specific checks, and re-review triggers are PelvicEx governance decisions. Internal records must be verifiable before PelvicEx makes any public claim of professional endorsement.