Guidelines should be guidelines: Time to leave the terms “consensus” and “position” for other purposes

Abstract

Guidelines should be guidelines: Time to leave the terms "consensus" and "position" for other purposes Clinical guidelines are "statements that include recommendations, intended to optimize patient care, that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options" [1]. Clinical guidelines are increasingly becoming a part of

Development and Publication of Clinical Practice Parameters, Reviews, and Meta-analyses: A Report From the Society of Cardiovascular Anesthesiologists Presidential Task Force

“…28 Practice advisories are systematically developed reports intended to assist decision-making in specific areas of patient care (Table 1). 26,32,33,[46][47][48] They differ from other clinical practice parameters (eg, practice guidelines and practice standards) in that the supporting scientific evidence is not as robust and lacks high-quality data such as large prospective, controlled studies. Rather, practice advisories are typically supported by expert or membership-based consensus, or opinion surveys, that complements the available evidence.…”

“…32 To counsel on the best possible and most acceptable way to address a particular decision-making area for diagnosis, management, or treatment. 33 To promote discussion on emerging topics, where evidence is lacking or uncertain. 33 To address specific aspects of patient management, patient care, and patient safety.…”

Approach Scientific Statements Like a Scouting Report?

“…It has been such a source of confusion that several have called for a clearer distinction between terms such as "guidelines," "consensus," and "position." 1,3,6 Thus, it is important to understand the ways in which statements differ in their development, strength of evidence, recommendations generated, and appropriateness of their use in different situations.…”

“…Adding the term “evidence based” before “treatment of knee osteoarthritis” dramatically reduced the number of results but the diversity in results remained (ie, systematic reviews, network meta-analyses, guidelines, clinical practice guidelines, etc). It has been such a source of confusion that several have called for a clearer distinction between terms such as “guidelines,” “consensus,” and “position.” 1,3,6 Thus, it is important to understand the ways in which statements differ in their development, strength of evidence, recommendations generated, and appropriateness of their use in different situations.…”

Response to

“…Guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and often follow the GRADE methodology (7). Alternatively, position papers rely more on expert opinion and promote discussion on topics for which evidence is lacking or uncertain (8). Currently, it was felt that the quantity of data available in the literature did not support the development of PALF clinical guidelines and what is presented reflects the work of the NASPGHAN Hepatology Committee with review and support from the broader NASPGHAN leadership.…”