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Revolutionize clinical-practice guidelines?


An article in JAMA poses the question:

Specialty society clinical practice guidelines: Time for Evolution or Revolution?

“The IOM  {Institute of Medicine} has strongly suggested that the current approach to development of CPGs {clinical practice guidelines} is flawed and fundamentally needs a new approach. Despite repetitive calls from many stakeholders for other entities to develop CPGs, to date, little has changed in the way most current CPGs are developed. Because of the many challenges in the current process, it will be difficult, if not impossible, for specialty societies to completely redirect the CPG development process to be effectively led by other entities.

“Therefore, to create CPGs that the public trusts, that clinicians and patients can readily implement, and for which compliance can be easily measured, the CPG development process should continue to be led by specialty societies but with a new model that integrates other stakeholders, including patients. Specialty societies will need to use a consortium process in which authors are not just from the specialty society ranks and the focus is on concise, rigorously evidence-based, highly practical, implementation- and measurement-focused CPGs with COI transparency. This approach could be disseminated broadly and adopted so that specialty society CPGs can be effectively used in critical efforts to improve the quality and safety of care and reduce cost.”

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