Author Affiliations: Departments of Medicine (Dr Cook) and Clinical Epidemiology (Drs Cook and Giacomini) and the Center for Health Economics and Policy Analysis (Dr Giacomini), McMaster University, Hamilton, Ontario. Dr Cook is a consulting editor for JAMA.
the validity of randomized trials,1
meta-analyses,2 diagnostic test studies,3 and
economic evaluations4 have challenged researchers to
improve the conduct of their studies and have encouraged readers to
interpret them carefully. The study by Shaneyfelt and
colleagues5 in this issue of THE
JOURNAL tackles the clinical practice guideline industry,
asking fundamental questions about how well they measure up to
contemporary standards. Most guidelines outlined their rationale,
specified the benefits and harms of health practices, and cited their
evidentiary sources. However, guidelines much less often described how
the evidence was found, how its worth was judged, and how diverse
sources of evidence were combined to formulate recommendations.
Cook D, Giacomini M. The Trials and Tribulations of Clinical Practice Guidelines. JAMA. 1999;281(20):1950-1951. doi:10.1001/jama.281.20.1950