Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review--guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Copyright 2011 by the National Academy of Sciences. All rights reserved.
- THE NATIONAL ACADEMIES
- COMMITTEE ON STANDARDS FOR DEVELOPING TRUSTWORTHY CLINICAL PRACTICE GUIDELINES
- Background and Key Stakeholders in Guidelines Development and Use
- Trustworthy Clinical Practice Guidelines: Challenges and Potential
- Current Best Practices and Proposed Standards for Development of Trustworthy CPGs: Part 1, Getting Started
- Current Best Practices and Standards for Development of Trustworthy CPGs: Part II, Traversing the Process
- Promoting Adoption of Clinical Practice Guidelines
- Development, Identification, and Evaluation of Trustworthy Clinical Practice Guidelines
- Appendix A Abbreviations and Acronyms
- Appendix B Workshop Agenda and Questions to Panelists
- Appendix C Clinical Practice Guideline Appraisal Tools
- Appendix D Systems for Rating the Strength of Evidence and Clinical Recommendations
- Appendix E Literature Search Strategy: Clinical Practice Guidelines
- Appendix F Committee Biographies
Guidelines for the Management of Degenerative Cervical Myelopathy and Acute Spinal Cord Injury: Development Process and MethodologyLA Tetreault et al. Global Spine J 7 (3 Suppl), 8S-20S. PMID 29164037.The Institute of Medicine defines clinical practice guidelines as "statements that include recommendations intended to optimize patient care that are informed by a system …
Critical Evaluation of Oncology Clinical Practice GuidelinesBN Reames et al. J Clin Oncol 31 (20), 2563-8. PMID 23752105. - ReviewThe vast majority of oncology CPGs fail to meet the IOM standards for trustworthy guidelines. On the basis of these results, there is still much to be done to make guidel …
Procedures and Methods of Benefit Assessments for Medicines in GermanyGE Bekkering et al. Eur J Health Econ 9 Suppl 1, 5-29. PMID 18987905.The Federal Joint Committee (FJC; Gemeinsamer Bundesausschuss, G-BA) defines the health-care elements that are to be reimbursed by sickness funds. To define a directive, …
Guidelines, Editors, Pharma and the Biological Paradigm ShiftAR Singh et al. Mens Sana Monogr 5 (1), 27-30. PMID 22058616.Private investment in biomedical research has increased over the last few decades. At most places it has been welcomed as the next best thing to technology itself. Much o …
An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain. Part I: Introduction and General ConsiderationsL Manchikanti et al. Pain Physician 16 (2 Suppl), S1-48. PMID 23615882. - ReviewIn 2011, the Institute of Medicine (IOM) re-engineered its definition of clinical guidelines as follows: "clinical practice guidelines are statements that include recomme …
Cited by 1 PubMed Central articles
Care That Matters: Quality Measurement and Health CareBG Saver et al. PLoS Med 12 (11), e1001902. PMID 26574742.Barry Saver and colleagues caution against the use of process and performance metrics as health care quality measures in the United States.