clinical practice guidelines

Meaning of clinical practice guidelines: Recommendations assembled from the evidence by a panel, written to inform a decision rather than to dictate what happens to any one person.

Definition of clinical practice guidelines

Clinical practice guidelines are structured recommendations on preventing, diagnosing or treating a particular condition, produced by a panel that has reviewed the available evidence systematically. Each recommendation usually carries a grade showing how strongly it is advised and how solid the evidence behind it is. Guidelines are issued by professional bodies, specialty societies and national agencies, and are revised as evidence accumulates.

How is a guideline built?

The panel starts by fixing the questions it will answer, since a guideline that tries to cover everything answers nothing usefully. Each question then gets a systematic search of the published literature, and the studies found are appraised for how well they were run rather than simply counted. Recommendations are drafted from what that body of evidence supports, graded, and sent out for comment before publication. Panel members declare financial and professional interests, because the same specialists who know a field best often have ties to it.

Why do two guidelines disagree?

ReasonHow it shows up
Different questions askedOne covers screening, another covers treatment
Different weighing of harmsScreening ages and intervals diverge
Different evidence cutoffsOne panel saw a clinical trial the other did not
Different populations in mindResources and disease frequency vary by country

Disagreement between respected bodies is therefore common and is not by itself a sign that one of them is careless. Where the evidence is strong the recommendations converge; where it is thin, judgment fills the gap and judgments differ.

What is a guideline not?

It is not a protocol, which sets out steps to be followed exactly, and it is not a legal standard, though it may be cited as evidence of what was reasonable. It describes what usually suits most people with a condition, and any individual may have reasons to depart from it. Two similar sounding phrases mean something else entirely: good clinical practice is the ethical and quality standard for running research on people, and a best practice is a single recommended way of doing one task rather than a reviewed body of recommendations.

Also known as

clinical guidelineevidence-based guidelinepractice guideline

Used in a sentence

The regimen was selected in line with current clinical practice guidelines.

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Good to know

The strength of a recommendation and the quality of the evidence supporting it are graded separately, so a firmly worded recommendation can rest on weak evidence where the alternative course carries obvious harm.

For learning, not diagnosis. This glossary provides general educational information and is not a substitute for advice from a qualified healthcare professional. If you may be experiencing a medical emergency, contact local emergency services.