Mastery of the rapidly expanding “evidence” base for the practice of medicine, coupled with the skills needed to synthesize that information for the treatment of individual patients, represents a nearly unachievable challenge for most practicing physicians. Clinical practice guidelines were originally developed to support clinical decision making in conjunction with physician knowledge and experience. However, clinical practice guidelines are now being used for broader purposes: as institutional policy, to inform insurance coverage, for deriving quality of care criteria, and for medicolegal liability standards. The broadening uses of clinical practice guidelines and the recent proliferation of both systematic reviews1 and clinical practice guidelines produced by specialty societies raise 2 concerns: (1) Is the process of development of these “guidelines” adequate to support the expanded uses? and (2) Once developed, how should clinical practice guidelines be evaluated and certified as trustworthy for the expanded purposes?
Greenfield S. Clinical Practice GuidelinesExpanded Use and Misuse. JAMA. 2017;317(6):594-595. doi:10.1001/jama.2016.19969