Current and future relevance of guidelines

Klein, Wendy

doi:10.1136/heart.87.6.497

Cited by 30 publications

(21 citation statements)

References 6 publications

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“…Nevertheless, as highlighted in our previous report (Cumming et al. 2001), guidelines are meant solely to guide but not dictate management, and we are in agreement with Klein (2002) as any attempt to standardize care ignores the heterogeneity of patients and the complexity of medical decisions. Each case therefore must always be considered individually.…”

Section: Discussionsupporting

confidence: 60%

“…Similarly, the evidence in favour of prophylactic surgery for unaffected HNPCC gene carriers is lacking, and therefore not generally recommended (Lindor et al 2006). Nevertheless, as highlighted in our previous report (Cumming et al 2001), guidelines are meant solely to guide but not dictate management, and we are in agreement with Klein (2002) as any attempt to standardize care ignores the heterogeneity of patients and the complexity of medical decisions. Each Multiple primary cancers © 2009 The Authors Journal compilation © 2009 Blackwell Publishing Ltd case therefore must always be considered individually.…”

Section: Discussionmentioning

confidence: 91%

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The genetic causes of the sequential occurrence of multiple primary malignancies in a young woman - 5 years on

Harry

Cumming

Narayansingh

et al. 2010

European Journal of Cancer Care

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The finding of three primary gynaecological malignancies in a young woman attending our unit was documented in 2001. We provide an update on this report as new events have prompted further discussion on the role of clinical guidelines in cancer management. The discovery of a genetic predisposition demonstrates the need for multidisciplinary input and heightened awareness in similar cases while the importance of treating each patient as an individual is emphasized.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 91%

The genetic causes of the sequential occurrence of multiple primary malignancies in a young woman - 5 years on

Harry

Cumming

Narayansingh

et al. 2010

European Journal of Cancer Care

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“…In fact, several recent studies found that the methodological quality of clinical guidelines was highly variable. The problem is that there are many poor-quality CPGs that are not based on the best evidence [4], [5], [6]. Therefore, assessing the quality of CPGs using formal methods is necessary.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Quality of Clinical Practice Guidelines for Otorhinolaryngology in China

Zhang

Liu

et al. 2013

PLoS ONE

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ObjectiveTo evaluate the quality of clinical practice guidelines (CPGs) for otorhinolaryngology in China.Materials and MethodsA systematic search of relevant literature databases (CBM, WANFANG, VIP, CNKI, China Guideline Clearinghouse) published between 1978 and March 2012 was undertaken to identify and select CPGs related to otorhinolaryngology. Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Their degree of agreement was evaluated using the intraclass correlation coefficient (ICC).ResultFrom 170 citations, 21 relevant guidelines were included. The overall agreement among reviewers was moderate (ICC = 0.87; 95% confidence interval [CI], 0.78–0.91). The scores for each of the AGREE domains were the following: “scope and purpose” (mean ± standard error [SE] = 45.4±4.4; ICC = 0.92), “stakeholder involvement” (mean ± SE = 30.4±3.1; ICC = 0.81), “rigor of development” (mean ± SE = 20.9±2.8; ICC = 0.87), “clarity of presentation” (mean ± SE = 48.8±3.7; ICC = 0.80), “applicability” (mean ± SE = 12.6±1.7; ICC = 0.72), and “editorial independence” (mean ± SE = 6.2±0.8; ICC = 0.76). Three guidelines (14%) mentioned updates, and the average update frequency was 7 years. None used the GRADE system.ConclusionThe quality of otorhinolaryngology guidelines in China is low. Greater efforts are needed to provide high-quality guidelines that serve as a useful and reliable tool for clinical decision-making in this field.

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“…A = Aspirin and ACE inhibitors (ARBs) B = Beta blockers and blood pressure C = Cholesterol, cigarettes, clopidogrel D = Diet for weight control and diabetes E = Education and exercise I believe that guidelines are useful to help make clinical judgments and thus improve the quality of patient care. 5 However, the astute clinician will recognize that standardizing care may not be appropriate in every patient because of the heterogeneous nature of the patients being treated. In addition, guidelines are not static documents, and they must be continuously updated as new information evolves.…”

Section: Discussionmentioning

confidence: 99%

Guideline‐based Discharge Therapy for Unstable Angina Pectoris/Non‐ST Elevation Myocardial Infarction

Conti¹

2007

Clinical Cardiology

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Current and future relevance of guidelines

Cited by 30 publications

References 6 publications

The genetic causes of the sequential occurrence of multiple primary malignancies in a young woman - 5 years on

The genetic causes of the sequential occurrence of multiple primary malignancies in a young woman - 5 years on

Analysis of Quality of Clinical Practice Guidelines for Otorhinolaryngology in China

Guideline‐based Discharge Therapy for Unstable Angina Pectoris/Non‐ST Elevation Myocardial Infarction

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