A medical guideline (also called a clinical guideline and clinical protocol) is a document with the aim of guiding decisions and criteria in specific areas of healthcare, as defined by an authoritative examination of current evidence (evidence-based medicine). Guidelines usually include summarized consensus statements, but unlike the latter, they also address practical issues.

Clinical guidelines briefly identify, summarize and evaluate the best evidence and most current data about prevention, diagnosis, prognosis, therapy, 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. Thus, they integrate the identified decision points and respective courses of action to the clinical judgment and experience of practitioners.

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.

The guideline-based approach to healthcare is a relatively recent one and has originated in the United States in the 90s. 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. 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 have been developed to facilitate the production and use of medical guidelines. On-line medical literature databases (such as PubMed) and evidence-based medicine databases (such as the Cochrane Collaboration), and printed and electronic publications exist in large numbers for this purpose. The USA and other countries maintain medical guideline clearinghouses. Clinical guidelines may include or not decision or calculation algorithms.

Related topics

• Medical decision making
• Evidence-based medicine
• Consensus (medical)
• Algorithm (medical)

External links

• National Guideline Clearinghouse (http://www.guideline.gov/). US Agency for Research and Quality in Healthcare
• The Cochrane Collaboration (http://www.cochrane.org/)
• The PubMed Database (http://www.pubmed.com/). US National Library of Medicine.
• Guideline Interchange Format (http://www.glif.org/). The Guideline Interchange Format (GLIF) is a specification for structured representation of guidelines.