What are evidence-based guidelines?
Evidence-based guidelines, also called clinical practice guidelines, "are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" (Institute of Medicine; 1990, p. 381; 2001, p. 1512). According to the National Guideline Clearinghouse (NGC), sponsored by the Agency on Healthcare Research and Quality (AHRQ), such "guidelines are not fixed protocols that must be followed" (NGC, 2007) but are intended to identify generally recommended interventions to be considered by a knowledgeable healthcare provider.
Guidelines are developed by panels or groups of experienced individuals who carefully weigh syntheses of evidence and the strength of the evidence before developing recommendations for interventions. As each individual is unique and presents different characteristics, professional caregivers must consider the treatment options that are appropriate for the specific situation.
Many professional organizations have embarked on developing guidelines for their fields. In rehabilitation, many disciplines may be represented for a specific patient, adding to the quantity of information and options that must be considered.
We present a number of resources for clinical practice guidelines, and in addition, several guidelines for developing and presenting evidence-based guidelines. Each of the following resources is identified with a brief description and one or more links to pertinent Web sites.
1 Institute of Medicine. (1990). Clinical Practice Guidelines: Directions for a New Program. M.J. Field and K.N. Lohr (eds.) Washington, DC: National Academy Press. (p.38)
2 Institute of Medicine, Committee on Quality Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. (p.151)
AIDSInfo Clinical Guidelines
Guidelines for the medical management of HIV infection and issues surrounding HIV infection. This technical information is useful for health care providers, but patients, friends, and family members are encouraged to review and discuss with doctors, nurses, & others on their healthcare team.
The Appraisal of Guidelines Research and Evaluation (AGREE) Enterprise is an international endeavour aimed at improving the quality of practice guidelines. The potential benefits of practice guidelines are only as good as the quality of the guidelines themselves. To address the variability in practice guideline quality, the AGREE Enterprise was initiated with the development of the original AGREE Instrument.
American Academy of Neurology
The AAN database has clinical practice guidelines and related tools to assist its members in clinical decision making related to the prevention, diagnosis, treatment, and prognosis of neurologic disorders.
This web site contains a database of web-based Evidence-based Clinical Practice Guidelines from recent scientific publications. This database is a teaching and reference tool that will allow students and rehabilitation specialists alike to make informed decisions in choosing an effective intervention for their client. This initiative is funded by the Centre for University Teaching (University of Ottawa) and the Consortium national de formation en santé.
Guidelines International Network (G-I-N)
International not-for-profit association of organizations & individuals involved in clinical practice guidelines. G-I-N seeks to improve the quality of health care by promoting systematic development of clinical practice guidelines and their application into practice, through supporting international collaboration. G-I-N's International Guidelines Library contains guidelines, evidence reports and related documents, developed or endorsed by G-I-N member organisations.
National Guideline Clearinghouse (NGC)
The National Guideline Clearinghouse™ (NGC) is a comprehensive database of evidence-based clinical practice guidelines and related documents, sponsored by AHRQ. Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. NGC was originally created by AHRQ in partnership with the American Medical Association and the American Association of Health Plans (now America's Health Insurance Plans [AHIP])
National Quality Measures Clearinghouse (NQMC)
The National Quality Measures Clearinghouse™ (NQMC), sponsored by AHRQ, U.S. Department of Health and Human Services, is a database and Web site for information on specific evidence-based health care quality measures and measure sets. Its purpose is to promote widespread access to quality measures
NICE: National Institute for Health and Clinical Excellence
NICE is the independent organization in the UK responsible for providing national guidance on promoting good health and preventing and treating ill health, in line with the best available evidence of effectiveness and cost effectiveness.
Also sponsored by AHRQ, QualityTools is a Web-based clearinghouse for practical, ready-to-use tools for measuring and improving the quality of healthcare. AHRQ defines a "tool" as a Web site, database, report, fact sheet, guide, or other mechanism to assist health care professionals, policymakers, health plans, employers, patients, and consumers in the development, promotion, or enhancement of health care quality within a practice, organization, or in an individual's daily life.
SIGN: Scottish Intercollegiate Guidelines Network
SIGN was established in 1993 to develop evidence based national guidelines for NHS Scotland. SIGN developed a hierarchy of study types as well as key stages in developing recommendations. The SIGN guide to the AGREE guideline appraisal instrument describes how SIGN guidelines attempt to address each of the AGREE domains. There is also a comparison of SIGN and NICE.
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