TAILIEUCHUNG - Chapter 003. Decision-Making in Clinical Medicine (Part 11)

Clinical Practice Guidelines According to the 1990 Institute of Medicine definition, clinical practice guidelines are "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." This definition provides emphasis to several crucial features of modern guideline development. First, guidelines are created using the tools of EBM. In particular, the core of the development process is a systematic literature search followed by a review of the relevant peer-reviewed literature. Second, guidelines are usually focused around a clinical disorder (., adult diabetes, stable angina pectoris) or a health care intervention (., cancer screening). . | Chapter 003. Decision-Making in Clinical Medicine Part 11 Clinical Practice Guidelines According to the 1990 Institute of Medicine definition clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. This definition provides emphasis to several crucial features of modern guideline development. First guidelines are created using the tools of EBM. In particular the core of the development process is a systematic literature search followed by a review of the relevant peer-reviewed literature. Second guidelines are usually focused around a clinical disorder . adult diabetes stable angina pectoris or a health care intervention . cancer screening . Third guidelines are intended to assist decision-making not to define explicitly what decisions should be made in a particular situation. The primary objective is to improve the quality of medical care by identifying areas where care should be standardized based on compelling evidence. Guidelines are narrative documents constructed by an expert panel whose composition is often chosen by interested professional organizations. These panels vary in the degree to which they represent all relevant stakeholders. The guideline documents consist of a series of specific management recommendations a summary indication of the quantity and quality of evidence supporting each recommendation and a narrative discussion of the recommendations. Many recommendations have little or no supporting evidence and thus reflect the expert consensus of the guideline panel. In part to protect against errors by individual panels the final step in guideline construction is peer review followed by a final revision in response to the critiques provided. Guidelines are closely tied to the process of quality improvement in medicine through their identification of evidence-based best practices. Such practices can be used as quality .

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