In Reply: We recognize that many excellent guidelines exist. We object to calling recommendations guidelines unless they meet rigorous standards. Expert opinions are important but should be labeled expert opinions rather than guidelines. The presence of fewer guidelines might actually have a greater effect on health care than the current explosion of guidelines. If guideline committees wrote 2 parallel reports—one presenting guidelines and another identifying issues that need more data and for which only expert opinion can be given—then practicing physicians would better understand those issues that deserve guidelines.
Shaneyfelt TM, Centor RM. Clinical Practice Guidelines and Scientific Evidence—Reply. JAMA. 2009;302(2):142-147. doi:10.1001/jama.2009.918