Practice Guideline
Definition
A statement produced by a panel of experts that outlines current best practice to inform health care professionals and patients in making clinical decisions. The statement is produced after an extensive review of the literature and is typically created by professional associations, government agencies, and/or public or private organizations.
Good guidelines clearly define the topic; appraise and summarize the best evidence regarding prevention, diagnosis, prognosis, therapy, harm, and cost-effectiveness; and identify the decision points where this information should be integrated with clinical experience and patient wishes to determine practice. Practice guidelines should be reviewed frequently and updated as necessary for continued accuracy and relevancy.
Practice guidelines are also known as "Evidence-based guidelines" and "Clinical guidelines."
Advantages
- Created by panels of experts
- Based on professional published literature
- Practical guidance for clinicians
- Considered an evidence-based resource
Disadvantages
- Slow to change or be updated
- Not always available, especially for controversial topics
- Expensive and time-consuming to produce
- Recommendations might be affected by the type of organization creating the guideline
Design pitfalls to look out for
The panel should be composed of a variety of experts with assorted affiliations.
Is the panel composed of members from a variety of professional associations, government agencies and/or institutes? Does one organization/association predominate?
Fictitious Example
A practice guideline focusing on the best way to prevent sunburn when wearing sunscreen involved forming a multidisciplinary panel of experts (dermatologists, oncologists, sunscreen chemists, etc.). These experts searched the literature and identified 123 research articles on sunscreen and sunburn prevention for appraisal. The research was then reviewed by a member of the panel with critical appraisal experience in order to identify only those high-quality research articles that permit making recommendations. Ninety-seven high-quality studies were selected. These articles were read and synthesized by the panel to create a formal guideline recommendation. Based on the literature, the guideline recommended that the best way to prevent sunburn is to wear UVA blocking sunscreen daily. However, there was insufficient evidence in the literature to make any recommendations about newer sunscreen formulations. This identified the need for further research on this topic.
Real-life Example
These guidelines were developed by multiple groups in the wound care community including clinicians, researchers, industry, governing agencies and third-party payers. The panel recognized six categories including the positioning and support surfaces, nutrition, infection, wound bed preparation, dressings, surgery and adjuvant therapies.