International Journal for Quality in Health Care 15:31-045 (2003)
© 2003 International Society for Quality in Health Care
Paper |
Towards evidence-based clinical practice: an international survey of 18 clinical guideline programs
1Centre for Quality of Care Research (WOK), University Medical Centre Nijmegen, The Netherlands
2Department of Social Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
3Finnish Office for Health Care Technology Assessment, Helsinki, Finland
4St George’s Hospital Medical School, London, UK (coordinating center)
Objective. To describe systematically the structures and working methods of guideline programs.
Design. Descriptive survey using a questionnaire with 32 items based on a framework derived from the literature. Answers were tabulated and checked by participants.
Study participants. Key informants of 18 prominent guideline organizations in the United States, Canada, Australia, New Zealand, and nine European countries.
Main outcome measures. History, aims, methodology, products and deliveries, implementation, evaluation, procedure for updating guidelines, and future plans.
Results. Most guideline programs were established to improve the quality and effectiveness of health care. Most use electronic databases to collect evidence and systematic reviews to analyze the evidence. Consensus procedures are used when evidence is lacking. All guidelines are reviewed before publication. Authorization is commonly used to endorse guidelines. All guidelines are furnished with tools for application and the Internet is widely used for dissemination. Implementation strategies vary among different organizations, with larger organizations leaving this to local organizations. Almost all have a quality assurance system for their programs. Half of the programs do not have formal update procedures.
Conclusions. Principles of evidence-based medicine dominate current guideline programs. Recent programs are benefiting from the methodology created by long-standing programs. Differences are found in the emphasis on dissemination and implementation, probably due to differences in health care systems and political and cultural factors. International collaboration should be encouraged to improve guideline methodology and to globalize the collection and analysis of evidence needed for guideline development.
Keywords: clinical guidelines, evidence-based medicine, program, survey
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. M. Shaneyfelt and R. M. Centor Reassessment of Clinical Practice Guidelines: Go Gently Into That Good Night JAMA, February 25, 2009; 301(8): 868 - 869. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Nagy, J. Watine, P. S. Bunting, R. Onody, W. P. Oosterhuis, D. Rogic, S. Sandberg, K. Boda, and A. R. Horvath Do Guidelines for the Diagnosis and Monitoring of Diabetes Mellitus Fulfill the Criteria of Evidence-Based Guideline Development? Clin. Chem., November 1, 2008; 54(11): 1872 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Legido-Quigley, M. McKee, K. Walshe, R. Sunol, E. Nolte, and N. Klazinga How can quality of health care be safeguarded across the European Union? BMJ, April 26, 2008; 336(7650): 920 - 923. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Dartnell, M. Hemming, J. Collier, and G. Ollenschlaeger Putting evidence into context: some advice for guideline writers Evid. Based Nurs., January 1, 2008; 11(1): 6 - 8. [Full Text] [PDF]
|
|
|
|
 |
|
 L. Stevenson, C. McRae, and W. Mughal Moving to a culture of safety in community home health care J Health Serv Res Policy, January 1, 2008; 13(suppl_1): 20 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Stevenson, C. McRae, and W. A. Mughal Delineation of Risk Through the Exploration of a Culture of Safety in Community Home Health Home Health Care Management Practice, October 1, 2007; 19(6): 460 - 463. [Abstract] [PDF]
|
|
|
|
 |
|
 J. Dartnell, M. Hemming, J. Collier, and G. Ollenschlaeger Putting evidence into context: some advice for guideline writers Evid. Based Med., October 1, 2007; 12(5): 130 - 132. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Giesen, M. Willekens, H. Mokkink, J. Braspenning, W. Van Den Bosch, and R. Grol Out-of-hours primary care: development of indicators for prescribing and referring Int. J. Qual. Health Care, October 1, 2007; 19(5): 289 - 295. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E.C. Haagen, R.P.M.G. Hermens, W.L.D.M. Nelen, D.D.M. Braat, R.P.T.M. Grol, and J.A.M. Kremer Subfertility guidelines in Europe: the quantity and quality of intrauterine insemination guidelines Hum. Reprod., August 1, 2006; 21(8): 2103 - 2109. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Clark, E. F. Donovan, and P. Schoettker From outdated to updated, keeping clinical guidelines valid Int. J. Qual. Health Care, June 1, 2006; 18(3): 165 - 166. [Full Text] [PDF]
|
|
|
|
 |
|
 A Hutchings, R Raine, C Sanderson, and N Black An experimental study of determinants of the extent of disagreement within clinical guideline development groups Qual. Saf. Health Care, August 1, 2005; 14(4): 240 - 245. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Fervers, J. S. Burgers, M. C. Haugh, M. Brouwers, G. Browman, F. Cluzeau, and T. Philip Predictors of high quality clinical practice guidelines: examples in oncology Int. J. Qual. Health Care, April 1, 2005; 17(2): 123 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Ollenschlager, C Marshall, S Qureshi, K Rosenbrand, J Burgers, M Makela, J Slutsky, and for the Board of Trustees 2002, Guidelines Interna Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N) Qual. Saf. Health Care, December 1, 2004; 13(6): 455 - 460. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.S. Burgers, B. Fervers, M. Haugh, M. Brouwers, G. Browman, T. Philip, and F.A. Cluzeau International Assessment of the Quality of Clinical Practice Guidelines in Oncology Using the Appraisal of Guidelines and Research and Evaluation Instrument J. Clin. Oncol., May 15, 2004; 22(10): 2000 - 2007. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Nathwani From evidence-based guideline methodology to quality of care standards J. Antimicrob. Chemother., May 1, 2003; 51(5): 1103 - 1107. [Full Text] [PDF]
|
|