Health care practitioners rely on clinical practice guidelines to provide evidence-based, unbiased recommendations for patient care. Ideally, guidelines are as definitive as possible, developed through a rigorous and systematic review of the most current and relevant evidence, followed by formal consensus building among a diverse and unconflicted group of stakeholders and experts. In reality, clinicians are faced with a surplus of clinical practice guidelines of widely variable quality, many based primarily on the opinions of a self-selected group of experts whose work is not sufficiently transparent with respect to principles for guideline development, evidence review, or potential conflicts of interest. In 2011, the Institute of Medicine (IOM) released its report Clinical Practice Guidelines We Can Trust,1 establishing best practices and quality standards to inform the development of clinical practice guidelines, including managing conflicts of interest, engaging a diverse set of stakeholders, conducting systematic reviews, rating evidence (eg, the GRADE [Grading of Recommendations, Assessment, Development and Evaluations] framework), and articulating recommendations. Implementing these IOM standards led to the removal of nearly 50% of the 2619 guidelines on the now-defunded National Guideline Clearinghouse between 2014 and 2018.2
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Incze M, Ross JS. On the Need for (Only) High-Quality Clinical Practice Guidelines. JAMA Intern Med. 2019;179(4):561. doi:10.1001/jamainternmed.2018.7471
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