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07-SEPTEMBER-2008 03:17:44 - Medical guideline Redirected from Guideline medical A medical guideline also called a clinical guideline, clinical protocol or clinical practice guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. Such documents have been in use for thousands of years during the entire history of medicine. However, in contrast to previous approaches, which were often based on tradition or authority, modern medical guidelines are based on an examination of current evidence within the paradigm of evidence-based medicine. They usually include summarized consensus statements, but unlike the latter, they also address practical issues. Modern clinical guidelines briefly identify, summarize and evaluate the best evidence and most current data about prevention, diagnosis, prognosis, therapy including dosage of medications, risk/benefit and cost-effectiveness. Then they define the most important questions related to clinical practice and identify all possible decision options and their outcomes. Some guidelines contain decision or computation algorithms to be followed. Thus, they integrate the identified decision points and respective courses of action to the clinical judgment and experience of practitioners. Many guidelines place the treatment alternatives into classes to help providers in deciding which treatment to use. Additional objectives of clinical guidelines are to standardize medical care, to raise quality of care, to reduce several kinds of risk to the patient, to the healthcare provider, to medical insurers and health plans and to achieve the best balance between cost and medical parameters such as effectiveness, specificity, sensitivity, resolutiveness, etc. It has been demonstrated repeatedly that the use of guidelines by healthcare providers such as hospitals is an effective way of achieving the objectives listed above, although they are not the only ones. Special computer software packages known as guideline execution engines have been developed to facilitate the use of medical guidelines in concert with an electronic medical record system. The Guideline Interchange Format GLIF is a computer representation format for clinical guidelines that can be used with such engines.1 It has been found2 that some simple clinical practice guidelines are not routinely followed to the extent they might be. It has been found that providing a nurse or other medical assistant with a checklist of recommended procedures can result in the attending physician being reminded in a timely manner regarding procedures that might have been overlooked. The guideline-based approach to healthcare is a relatively recent one and has originated in the United States in the 1990s. Guidelines are usually produced at national or international levels by medical associations or governmental bodies, such as the US Agency for Healthcare Research and Quality. Local healthcare providers may produce their own set of guidelines or adapt them from existing top-level guidelines. The USA and other countries maintain medical guideline clearinghouses. In the USA, the National Guideline Clearinghouse maintains a catalog of high-quality guidelines published by various organizations mostly professional physician organizations. In the United Kingdom, clinical practice guidelines are published primarily by the National Institute for Health and Clinical Excellence NICE. In The Netherlands, two bodies CBO and NHG publish specialist and primary care guidelines, respectively. In Germany, the German Agency for Quality in Medicine AEZQ coordinates a national program for disease management guidelines. All these organisations are now members of the Guidelines International Network, an international not-for-profit association of organisations and individuals involved in clinical practice guidelines. G-I-N is owner of the International Guideline Library - the largest web based data base of medical guidelines worldwide. See also Treatment Guidelines from The Medical Letter Medical decision making Evidence-based medicine Consensus medical Algorithm medical Clinical protocol cf. first line of the present article References ^ GLIF website ^ Gina Kolata Program Coaxes Hospitals to See Treatments Under Their Noses. New York Times December 25, 2004. External links National Guideline Clearinghouse NGC, a public resource for evidence-based clinical practice guidelines. NGC is an initiative of the Agency for Healthcare Research and Quality AHRQ, U.S. Department of Health and Human Services The Cochrane Collaboration Guideline Interchange Format. The Guideline Interchange Format GLIF is a specification for structured representation of guidelines. Guideline Elements Model. The Guideline Elements Model GEM is an ASTM standard for the representation of practice guidelines in XML format. 2004 report Hospital Quality Alliance HQA, a project of the Hospital Quality Initiative HQI of the Centers for Medicare and Medicaid Services CMS Scottish Intercollegiate Guidelines Network SIGN. Contains 113 evidence-based clinical guidelines - published, in development, or under review. Retrieved from http://en..org/wiki/Medical_guideline Categories: Medical literature | Medical informatics | Medical terms | Healthcare quality | Medical guidelines Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch 日本語 This page was last modified on 27 August 2008, at 23:15

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