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Medical Guidelines

A medical guideline (clinical guideline, standard treatment guideline) is a document that lays out best practices on how to diagnose, manage and treat a medical condition.

Medical guidelines summarize the current medical knowledge, provide guidance and give specific recommendations about how to diagnose and treat a specific condition and provide information about the scientific evidence supporting these recommendations. This evidence needs to be based on rigorous systematic review and synthesis of the published medical literature.

Medical guidelines are not legally binding, fixed protocols but support the healthcare professional by describing generally recommended courses of intervention.

“Guidelines help clinicians translate best evidence into best practice. A well-crafted guideline promotes quality by reducing healthcare variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective – or potentially harmful – interventions.”

R. Rosenfeld and R. Shiffman in “Clinical practice guideline development manual: A quality-driven approach for translating evidence into action”(1)

How are medical guidelines developed?

Medical guidelines are generally developed and published by the appropriate medical societies (more on medical societies). The process requires a significant investment in time and resources and typically consists of 5 steps:

  1. Identifying and refining the subject area/topic, e.g. a condition, procedure or signs and symptoms.
  2. Convening and running guideline multi-disciplinary development groups which should include content experts in addition to other relevant stakeholders such as nursing and allied health professionals as well as consumers. The committee is usually led by a member of the medical association responsible for the medical condition.
  3. Assessing evidence identified by systematic literature review with the goal to identify the best evidence from all relevant sources.
  4. Translating evidence into recommendations
  5. Subjecting the guideline to external review

Developing, reviewing and publishing medical guidelines typically takes around 12 months. Once published the guidelines need to be kept up-to-date through regular revisions.

What medical guidelines are not

While medical guidelines are important recommendations, they are not guidelines for reimbursement policies, performance measures, legal precedents, measures of certification or licensing and not treatment “recipes” that supersede professional judgement.