Clinical Practice Guidelines We Can Trust

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National Academies Press, Jul 16, 2011 - Medical - 290 pages
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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.

 

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Contents

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SUMMARY 1
INTRODUCTION 11
BACKGROUND AND KEY STAKEHOLDERS IN GUIDELINES DEVELOPMENT 21
CHALLENGES AND 39
CURRENT BEST PRACTICES AND PROPOSED STANDARDS FOR DEVELOPMENT 57
CURRENT BEST PRACTICES AND STANDARDS FOR DEVELOPMENT OF 83
PROMOTING ADOPTION OF CLINICAL PRACTICE GUIDELINES 111
DEVELOPMENT IDENTIFICATION AND EVALUATION OF TRUSTWORTHY 143
A Abbreviations and Acronyms 155
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