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 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. Health care or healthcare is one of the worlds largest and fastest growing professions. ... Evidence-based medicine (EBM) applies the scientific method to medical practice. ... Medical consensus is a public statement on a particular aspect of medical knowledge available at the time it was written, and that is generally agreed upon as the evidence-based, state-of-the-art (or state-of-science) knowledge by a representative group of experts in that area. ...

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. Many guidelines place the treatment alternatives into classes to help providers in deciding which treatment to use. A 1930 Soviet poster propagating breast care. ... Diagnosis (from the Greek words dia = by and gnosis = knowledge) is the process of identifying a disease by its signs, symptoms and results of various diagnostic procedures. ... ... Look up Therapy in Wiktionary, the free dictionary Therapy (in Greek: θεραπεία) or treatment is the attempted remediation of a health problem, usually following a diagnosis. ... Risk-benefit analysis is the comparison of the risk of a situation to its related benefits. ... Decision making is the cognitive process of selecting a course of action from among multiple alternatives. ...

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. Standardization, in the context related to technologies and industries, is the process of establishing a technical standard among competing entities in a market, where this will bring benefits without hurting competition. ... Quality refers to the distinctive characteristics or properties of a person, object, process or other thing. ... Risk is the potential impact (positive or negative) to an asset or some characteristic of value that may arise from some present process or from some future event. ... Health Insurance is a type of insurance whereby the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. ... Effectiveness means the capability of, or success in, achieving a given goal. ...

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. A hospital today is an institution for professional health care provided by physicians and nurses. ...

Special computer software packages have been developed to facilitate the production and use of medical guidelines. (guideline execution engine). Healthcare workflow is concerned with coordinating task done by different personnel. 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. A screenshot of computer software in action. ... This article needs to be cleaned up to conform to a higher standard of quality. ... A database is an information set with a regular structure. ... A clearing house is an organization affiliated with a securities or derivatives exchange that completes the transactions on that exchange by seeing to validation, delivery, and settlement. ... A medical algorithm is any algorithm, i. ...

It has been found^[1] 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. A nurse is a health care professional who is engaged in the practice of nursing. ... 1. ...

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. The National Institute for Health and Clinical Excellence or NICE is an agency of the National Health Service in the United Kingdom. ...

See also

• Medical decision making
• Evidence-based medicine
• Consensus (medical)
• Algorithm (medical)
• Clinical protocol (cf. first line of the present article)

Decision making is the cognitive process of selecting a course of action from among multiple alternatives. ... Evidence-based medicine (EBM) applies the scientific method to medical practice. ... Medical consensus is a public statement on a particular aspect of medical knowledge available at the time it was written, and that is generally agreed upon as the evidence-based, state-of-the-art (or state-of-science) knowledge by a representative group of experts in that area. ... A medical algorithm is any algorithm, i. ... This article needs to be cleaned up to conform to a higher standard of quality. ...

Reference

• ↑  Gina Kolata Program Coaxes Hospitals to See Treatments Under Their Noses. New York Times December 25, 2004. Article (site requires registration and payment of a fee).

Gina Kolata is a science reporter for The New York Times. ... The New York Times is an internationally known daily newspaper published in New York City and distributed in the United States and many other nations worldwide. ...

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 & Medicaid Services (CMS)