Clinical Practice Guidelines for Ureteral Stones: Implications in Japan and Limitations

Abstract

Owing to the development of systematic and structured abstraction methods, evidence-based guidelines have been proposed in many disciplines. mainly in the United States of America [1]. A social background which forces practitioners to draw up clinical guidelines is especially strong in the USA, where the medical supply system is exposed to a market economy. The problem of escalating medical costs in the USA prompted the government and the medical insurance companies to introduce clinical practice guidelines. These guidelines were introduced to control medical costs and quality, because many studies had shown wide variations in physician practice patterns and the use of the health services [1]. The health services are used inappropriately in some cases, and the health outcome is made uncertain by the use or nonuse of the various services and procedures. Initially, it was mainly the users of the services who began to develop guidelines, but professionals soon recognized the importance of clinical practice guidelines. The involvement of diverse groups in guidelines development has intensified the need to create and improve scientific methods to develop these guidelines, otherwise they will not be accepted by all groups whatever their economic interests and attitudes.