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Clinical Chemistry 52: 3-4, 2006; 10.1373/clinchem.2005.059345
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(Clinical Chemistry. 2006;52:3-4.)
© 2006 American Association for Clinical Chemistry, Inc.

Editorials

Guideline Quality and Guideline Content: Are They Related?

Jako S. Burgers

Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands, and, Dutch Institute for Healthcare Quality CBO, Utrecht, The Netherlands

Address for correspondence: Dutch Institute for Healthcare Quality CBO, Churchillaan 11, PO Box 20064, 3502 LB Utrecht, The Netherlands. Fax 31-30-294-3644; e-mail j.burgers@cbo.nl.

The first 20% of the full text of this article appears below.

Evidence-based medicine (EBM) challenges clinicians and laboratory professionals to make rational decisions in healthcare. Clinical practice guidelines embody the principles of EBM in making options and choices explicit, considering the scientific evidence and resources available (1). The evidence is often limited or controversial, however, and resources differ among countries and regions. Therefore, the translation of research evidence into recommendations for clinical practice is not straightforward. Judgment beyond the evidence is necessary, taking into consideration the balance between benefits and harms and risks, patients’ views and preferences, and potential organizational and financial barriers (2). Addressing these issues requires careful discussions within a working group that includes representatives from all relevant disciplines. In contrast to the development of systematic reviews, guidelines cannot be produced in an academic "ivory tower" by a few experts.

When the evidence is not strong or not fully applicable to the patient population targeted in the guideline, the working group may depart from the evidence. In laboratory medicine, high-level diagnostic evidence is particularly scarce, and the link between diagnostic tests and better patient outcomes is often unknown (3). It thus comes as no surprise that the composition . . . [Full Text of this Article]




The following articles in journals at HighWire Press have cited this article:


Home page
 Qual Saf Health CareHome page
E. Ketola, M. Kaila, and M. Honkanen
Guidelines in context of evidence
Qual. Saf. Health Care, August 1, 2007; 16(4): 308 - 312.
[Abstract] [Full Text] [PDF]


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