Clinical practice guidelines

What are clinical practice guidelines?

Defined as "systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances"

Source: Field MJ, Lohr KN, editors. Clinical practice guidelines: directions for a new program. Washington, DC: National Academy Press; 1990.

Purpose of Clinical Practice Guidelines

The intent of clinical practice guidelines are to:

1. Improve the quality of patient care and health care outcomes
2. Summarizes research findings and male clinical decisions more transparent
3. Reduce inappropriate variation in practice
4. Promote efficient use of resources
5. Identify gaps in knowledge and prioritize research activities
6. Provide guidance for consumers and inform and empower patients
7. Inform public policy
8. Support quality control, including audits of clinician's or hospitals' practices

Source: Davis D, Joanne G, Palda VA, Handbook on Clinical Practice Guidelines, Canadian Medical Association July 2007 pg 3.

How to develop Clinical Practice Guidelines

See: 'Adaptation and development of Clinical Practice Guidelines' Davis D, Joanne G, Palda VA, Handbook on Clinical Practice Guidelines, Canadian Medical Association July 2007 pg. 5-16

Clinical Practice Guideline Tools

AGREE (Appraisal of Guidelines Research & Evaluation) Instrument

appraisal instrument used to assess the quality of clinical guidelines

http://www.agreecollaboration.org/instrument/

GRADE

grading quality of evidence and strength of recommendations

http://www.gradeworkinggroup.org/

SORT (Strength of Recommendation Taxonomy)

taxonomy used to grade the quality, quantity, and consistency of evidence

http://www.aafp.org/afp/20040201/548.html

SIGN (Scottish Intercollegiate Guideline Network) method

methodology for developing evidence based clinical guidelines for the National Health Services in Scotland

http://www.sign.ac.uk/guidelines/fulltext/50/index.html

Resources:

Canadian Medical Association (CMA) Infobase - clinical practice guidelines

Includes:

1. CMA handbook on Clinical Practice Guidelines
2. A guide to the CMA Handbook on Clinical Practice Guidelines.

http://mdm.ca/cpgsnew/cpgs/index.asp

Guidelines Advisory Committee (GAC)

http://www.gacguidelines.ca

Straus SE, Richardson WS, Glasziou P, Haynes RB., Evidence-based Medicine: How to Practice and Teach EBM, Third Edition. Churchill Livingstone: Edinburgh, 2005. pg 165-172