Abstract
Clinical practice guidelines are nowadays seen as a necessity in order to summarize an ever-burgeoning amount of published evidence into a simple format that practicing clinicians can read, digest and implement in order to improve a patient’s outcome. Their use has also been advocated to reduce the gap between bench and bedside, to standardize clinical practice with the avoidance of inappropriate variations, to reduce the risk of legal claims and as a tool for quality assurance. Indeed, even a cursory inspection of PubMed reveals just how vast the published evidence is. In 2009 alone, there were 7,082 papers published that are retrieved when searching on the term “critical care.” If we also consider other databases, with the knowledge that a significant issue exists concerning language bias and publication bias (Grégoire et al. 1995), the volume is even greater.
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References
Amerling R, Winchester JF, Ronco C (2008) Guidelines have done more harm than good. Blood Purif 26:73–76
Bertolini G, Rossi C, Anghileri A, Livigni S, Addis A, Poole D (2007) Use of Drotrecogin alfa (activated) in Italian intensive care units: the results of a nationwide survey. Intensive Care Med 33:426–434
Berwick DM (2008) The science of improvement. JAMA 299:1182–1184
Browman GP (2010) Evidence-based clinical practice guideline development: principles, challenges, and accountability to evidence. J Surg Oncol 101:1–2
Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM (2004) Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock. Intensive Care Med 30:536–555
Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008) Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 34:17–60
Ferrer R, Artigas A, Levy MM, Blanco J, González-Días G, Garnacho-Montero J, Ibáñez J, Palencia E, Quintana M, de la Torre-Prados MV, Edusepsis Study Group (2008) Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain. JAMA 299:2294–2303
Gao F, Melody T, Daniels DF, Giles S, Fox S (2005) The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study. Crit Care 9:R764–R770
GRADE Working Group (2004) Grading quality of evidence and strength of recommendations. Br Med J 328:1–8
Grégoire G, Derderian F, Le Lorier J (1995) Selecting the language of the publications included in a meta-analysis: is there a tower of babel bias? J Clin Epidemiol 48:159–163
Grilli R, Magrini N, Penna A, Mura G, Liberati A (2000) Practice guidelines developed by specialty societies. The need for a critical appraisal. Lancet 355:103–106
Grimshaw JM, Russell IT (1993) Achieving health gain through clinical guidelines. I: developing scientifically valid guidelines. Qual Health Care 2:243–248
Grol R (2010) Has guideline development gone astray? Yes. Br Med J 340:c306. doi:10.1136/bmj.c306
Guyatt G, Gutterman D, Baumann MH, Addrizzo-Harris D, Hylek EM, Phillips B (2006) Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians task force. Chest 129:174–182
Institute of Medicine (2009) Conflict of interest in medical research, education and practice. National Academics Press, Washington
Jaeschke R, Guyatt GH, Dellinger P, Schünemann H, Levy MM, Kunz R, Norris S, Bion J, GRADE Working Group (2008) Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. Br Med J 337:a744. doi:10.1136/bmj.a744
Kanji S, Perreault MM, Chant C, Williamson D, Burry L (2007) Evaluating the use of Drotrecogin alfa (activated) in adult severe sepsis: a Canadian multicenter observational study. Intensive Care Med 33:517–523
Landucci D (2004) The surviving sepsis guidelines: “lost in translation”. Crit Care Med 32:1598–1600
Levy MM, Pronovost PJ, Dellinger RP, Townsend S, Resar RK, Clemmer TP, Ramsay G (2004) Sepsis change bundles: converting guidelines into meaningful change in behavior and clinical outcome. Crit Care Med 320:S595–S597
Machado FR, Freitas FGR (2008) Controversies of surviving sepsis campaign bundles: should we use them? Shock 30:34–40
Marwick C, Davey P (2009) Care bundles: the holy grail of infectious risk management in hospital? Curr Opin Infect Dis 22:364–369
Poole D, Bertolini G, Garattini S (2008) Errors in the approval process and post-marketing evaluation of drotrecogin alfa (activated) for the treatment of severe sepsis. Lancet Infect Dis 9:67–72
Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, Sexton B, Hyzy R, Welsh R, Roth G, Bander J, Kepros J, Goeschel C (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355:2725–2732
Schünemann HJ, Jaeschke R, Cook DJ, Bria WF, El-Solh AA, Ernst A, Fahy BF, Gould MK, Horan KL, Krishnan JA, Manthous CA, Maurer JR, McNicholas WT, Oxman AD, Rubenfeld G, Turino GM, Guyatt G, ATS Documents Development and Implementation Committee (2006) An official ATS statement: grading the quality of evidence and strength of recommendations in ATS guidelines and recommendations. Am J Respir Crit Care Med 174:605–614
Shaneyfelt TM, Mayo-Smith MF, Rothwangl J (1999) Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer-reviewed medical literature. JAMA 281:1900–1905
Shekelle PG, Woolf SH, Eccles M, Grimshaw J (1999) Clinical guidelines: developing guidelines. Br Med J 318:593–596
The AGREE Collaboration (2003) Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care 12:18–23
Thomas KW (2007) Adoption of sepsis bundles in the emergency room and intensive care unit: a model for quality improvement. Crit Care Med 35:1210–1212
Wip C, Napolitano L (2009) Bundles to prevent ventilator-associated pneumonia: how valuable are they? Curr Opin Infect Dis 22:159–166
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Rhodes, A., Cecconi, M., Moreno, R. (2012). Why Guidelines Require Reform. In: Rello, J., Lipman, J., Lisboa, T. (eds) Sepsis Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03519-7_3
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DOI: https://doi.org/10.1007/978-3-642-03519-7_3
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