Article Abstract:
Practitioners must assess the validity of clinical practice guidelines before adopting the recommendations. Clinical practice guidelines aid decision-making about appropriate health care for specific cases. Guidelines should include all reasonable practice options for managing a health problem and all resulting consequences, including disease, death, quality of life, and costs. The probability that an intervention will cause a specific outcome must be based on relevant evidence from the medical literature or expert assessment. The evidence should be comprehensive and up-to-date. Methods used to determine the relative value of each treatment outcome should be reported and must incorporate patient preferences. Guideline currency is important and can be gauged by scanning the bibliography. Guidelines that have been peer reviewed and used by clinicians are increasingly likely to be valid.
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Article Abstract:
Physicians should consider whether the benefits of recommendations contained in medical guidelines outweigh the costs and possible harm. Baselines risks and changes in outcomes need to be included in the guidelines. Because recommendations vary depending on the range of effects on patients, the guidelines should be tested against these multiple effects. Guidelines can be used in a variety of ways, for example, to evaluate physician practices or to help in medical decision making, so the user should recognize how the guidelines are being utilized. The guidelines must apply to the patients being evaluated and should note the patient characteristics in enough detail so that physicians can feel confident in matching their patients with those the guidelines were created for. Guidelines should also be detailed enough to allow for their exact re-creation by other doctors.
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Article Abstract:
Pre-publication news reports about new treatments may cause doctors to prescribe the treatment to patients who may not necessarily benefit. When two two clinical trials of endarterectomy to prevent stroke were pre-published, many doctors began treating patients 80 years old or older. However, the studies were done on younger patients so it wasn't clear whether older patients would benefit.
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