Abstract
Clinical practice guidelines (CPGs) are suited tools for controlling and improving the effectiveness and efficiency of medical care. With the upcoming internet, the numbers of CPGs have increased rapidly, however, only few offer the attributes of good guidelines such as reliability/reproducibility, applicability, flexibility, clarity, multidisciplinary process, scheduled review and documentation of clinical and scientific evidence. Nearly identical criteria for appraisal of CPGs have been developed in many countries consisting of a checklist with questions concerning the quality of development, the content and format, and the applicability of the guideline. In the United States, guidelines which successfully passed the appraisal (or clearing) process, were stored in the National Guideline Clearinghouse, an internet-based database. A German counterpart is under construction, which will comprise clearing reports reviewing and appraising all existent guidelines covering a medical topic. Developing high-quality CPGs is a time consuming and expensive process. A widely accepted guideline for guideline development was published by the Scottish Intercollegiate Guideline Network.
CPGs touching neurosurgical topics are rare and often developed without neurosurgical participation. Due to the potential medico-economic impact of CPGs in the future, national neurosurgical societies and their international associations should play a more active role in the development and implementation of CPGs.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Appraisal of Guidelines for Research and Evaluation in Europe (AGREE) collaboration. Appraising clinical guidelines: EC BIOMED-2 project PL96–3669.http://www.sghms.ac.uk/phs/hceu/biomed.htm
Buchborn E (1997) Leitlinien - Richtlinienl - Standards, Risiko oder Chance für Arzt und Patient? Bayer Ärztebl 94: C 1622–1623
Bundesärztekammer, Kassenärztliche Bundesvereinigung (1997) Beurteilungskriterien für Leitlinien in der medizinischen Versorgung. Dt Ärztebl 94: A2154–2155 (English version, March 1999 -http://www.azq.de)
Bundesärztekammer, Kassenärztliche Bundesvereinigung (1998) Checkliste “Methodische Qualität von Leitlinien”, 1. Version, Gültigkeit: verlängert bis 31. 8. 1999. Dtsch Ärztebl 95: A-2576–2578 (English version, March 1999 -http://www.azq.de)
Clinical Standards Advisory Group (1994) Back pain. Report of a CSAG Committee on back pain. ISBN 0–11–321887–7
Cluzeau F, Littlejohns P, Grimshaw JM, Feder G (1997). Appraisal instrument for clinical guidelines. St George’s Hospital Medical School, Londonhttp://www.sghms.ac.uk/phs/hceu/clinguid.htm
Cluzeau F, Littlejohns P, Grimshaw JM, Feder G (1997). Appraising the quality of clinical guidelines in the UK. Annu Meet Int Soc Technol Assess Health Care 13: 242–248
Conroy M, Shannon W (1995) Clinical guidelines: their implementation in general practice. Br J Gen Pract 45: 371–375
Effective Health Care. Implementing clinical practice guidelines (1994) Can guidelines be used to improve practice? University of Leeds, Leeds
Field MJ, Lohr KN (1990) Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines. Clinical practice guidelines: directions for a new program. National Academy Press, Washington DC
Gerlach FM, Beyer M, Szecsenyi J, Fischer GC (1998) Leitlinien in Klinik und Praxis. Dt Ärztebl 95: 1014–1021
“Guidelines for Guidelines” Advisory Committee (1996) Principles to guide the evaluation of clinical practice guidelines. Adis International, Auckland
Guyatt GH, Sackett DL, Sinclair JC, Hayward R, Cook DJ, Cook RJ (1995) Users’ guides to the medical literature. IX. A method for grading health care recommendations. Evidence-Based Medicine Working Group. JAMA 274: 1800–1804
Hayward RSA, Wilson MC, Tunis SR, Bass EB, Guyatt G, for the Evidence-Based Medicine Working Group (1995) Users’ guides to the medical literature. VIII. How to use clinical practice guidelines. A. Are the recommendations valid? JAMA 274: 570–574
Hayward RSA, Wilson MC, Tunis SR, Bass EB, Guyatt G, for the Evidence Based Medicine Working Group: How to use a clinical practice guideline. Centres for health evidence.net.http://www.cche.net/principles/content_pguideline.asp
Helou A, Perleth M, Bitzer EM, Doming H, Schwartz FW (1998) Methodische Qualität ärztlicher Leitlinien in Deutschland. ZaeFQ 92: 421–428
Lohr KN, Field MJ (1992) A provisional instrument for assessing clinical practice guidelines. In: Field MJ, Lohr KN (eds) Guidelines for clinical practice. From development to use. National Academy Press, Washington D.C.
Lorenz W, 011enschläger G, Geraedts M, Gerlach FM, Gand-jour A, Helou A, Kirchner H, Koller M, Lauterbach KW, Reinauer H, Sitter H, Thomeczek C (2000) Das Leitlinienmanual von AWMF und AZQ. Entwicklung und Implementierung von Leitlinien in der Medizin. ZaeFQ in press. Online:http://www.uni-duesseldorf.de/WWW/AWMF/11/index.html
McEleny P, Bowie P, Robins JB, Brown RC (1998) Getting a validated guideline into local practice: implementation and audit of the SIGN guideline on the prevention of deep vein thrombosis in a district general hospital. Scot Med J 43: 23–5
Ollenschläger G, Helou A, Kostovic-Cilic L, Perleth M, Raspe HH, Reinhoff O, Selbmann HK, Oesingmann U (1998). Die Checkliste zur methodischen Qualität von Leitlinien: ein Beitrag zur Qualitätsförderung ärztlicher Leitlinien. ZaeFQ 92: 191–194
Randall G, Taylor DW (2000). Clinical practice guidelines: the need for improved implementation strategies. Health Manage Forum 13: 36–42
Royal College of General Practitioners (1998) Clinical Guidelines for the management of acute low back pain., VI, 35 S. ISBN 0–85084–229–8http://www.rcgp.org.uk/college/activity/qualclin/guides/backpain/index.htm.
Scottish Intercollegiate Guidelines Network (SIGN) Clinical guidelines (1995) Criteria for appraisal for national use. Edinburghhttp://www.sign.ac.uk/
Scottish Intercollegiate Guidelines Network (SIGN) (1999) An introduction to SIGN methodology for the development of evidence-based clinical guidelines. Edinburghhttp://www.sign.ac.uk/
Scottish Intercollegiate Guidelines Network (SIGN). Revised method of grading guideline recommendations. Edinburghhttp://www.sign.ac.uk/
Sturmberg JP (1999) Implementing best practice guidelines: the influence of personal characteristics. J Eval Clin Pract 5: 223–226
US Department of Health and Human Services. Agency for Health Care Policy and Research (1993) Acute pain management: operative or medical procedures and trauma. Rockville (MD): The agency: clinical practice guideline no. 1. AHCPR Publication No. 92–0023. p 107
Ward JE, Grieco V (1996) Why we need guidelines for guidelines: a study of the quality of clinical practice guidelines in Australia. MJA 165: 574–576
Wilson MC, Hayward RS, Tunis SR, Bass EB, Guyatt G (1995) Users’ guides to the Medical Literature. VIII. How to use clinical practice guidelines. B. what are the recommendations and will they help you in caring for your patients? The Evidence-Based Medicine Working Group. JAMA 274: 1630–1632
Correspondence: Prof. Dr. med Wolf-Ingo Steudel, Department of Neurosurgery, Saarland University Medical School, D-66421 Homburg/Saar, Germany.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2001 Springer-Verlag Wien
About this paper
Cite this paper
Steudel, WI., Schwerdtfeger, K. (2001). Guidelines for Guidelines. In: Steiger, HJ., Uhl, E. (eds) Risk Control and Quality Management in Neurosurgery. Acta Neurochirurgica Supplements, vol 78. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6237-8_41
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6237-8_41
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7275-9
Online ISBN: 978-3-7091-6237-8
eBook Packages: Springer Book Archive