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J Am Board Fam Med. 2016 Nov 12;29(6):644-648. doi: 10.3122/jabfm.2016.06.160115.

The Need to Systematically Evaluate Clinical Practice Guidelines.

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From the Department of Family Medicine, Tufts University School of Medicine, Tufts University Family Medicine Residency at Cambridge Health Alliance, Boston, MA (AFS); the Department of Counseling and School Psychology, University of Massachusetts, Boston (LC); and the School of Health Policy and Management, York University, Toronto, Canada (JRL).


Clinical practice guidelines abound. The recommendations contained in these guidelines are used not only to make decisions about the care of individual patients but also as practice standards to rate physician "quality." Physicians' confidence in guidelines is based on the supposition that there is a rigorous, objective process for developing recommendations based on the best available evidence. Though voluntary standards for the development of guidelines exist, the process of guideline development is unregulated and the quality of many guidelines is low. In addition, the few tools available to assess the quality of guidelines are time consuming and designed for researchers, not clinicians. Few guidelines are evaluated, either before or after their dissemination, for their impact on patient outcomes. Just as with pharmaceuticals and other products that can affect patients for better or worse, perhaps it is time to develop more standardized ways to evaluate the development and dissemination of clinical practice guidelines to ensure a similar balance between risk and benefit.

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