Abstract
Clinical practices guidelines (CPGs) play a fundamental role in improving healthcare
and patients’ outcomes by helping clinicians make the best evidence-based decisions
for their patients in a time-efficient manner. By following the available methods
and criteria to create trustworthy CPGs, panel members can develop high-quality guidelines.
However, despite the improvements over the years, CPGs are still subjected to biases
and limitations, with conflicts of interest being the ugliest problem GCPs must face.
In this review, we discuss the main characteristics of clinical practice guidelines,
their pros and cons, and the future challenges they need to overcome.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Clinical practice guidelines we can trust.National Academies Press, Washington, D.C.2011
- Clinical guidelines: Potential benefits, limitations, and harms of clinical guidelines.BMJ. 1999; 318: 527-530
- Clinical practice guidelines: a primer on development and dissemination.Mayo Clin Proc. 2017; 92: 423-433
- Developing a checklist for guideline implementation planning: review and synthesis of guideline development and implementation advice.Implement Sci. 2015; 10: 19
- Practice guidelines, a new reality in medicine.Arch Intern Med. 1992; 152: 946
- Evidence-based medicine (editorial).ACP J Club. 1991; 114: A16
- Clinical practice guidelines.National Academies Press, Washington, D.C.1990
- Reassessment of clinical practice guidelines.JAMA. 2009; 301: 868
- Users’ guides to the medical literature. A manual for evidence-based clinical practice.3r ed. JAMA Evidence, 2015
- Validity of the agency for healthcare research and quality clinical practice guidelines.JAMA. 2001; 286: 1461
- Evidence-based medicine. A new approach to teaching the practice of medicine.JAMA. 1992; 268: 2420-2425
- What is GRADE? | BMJ Best Practice [Internet].2021 ([citedOct 29]. Available from:)
- A guide for health professionals to interpret and use recommendations in guidelines developed with the GRADE approach.J Clin Epidemiol. 2016; 72: 45-55
- AGREE II: advancing guideline development, reporting, and evaluation in health care.Prev Med. 2010; 51: 421-424
- The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines.BMJ. 2016; 352: i1152
- Re-evaluation of low intensity pulsed ultrasound in treatment of tibial fractures (TRUST): randomized clinical trial.BMJ. 2016; 355: i5351
- Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials.BMJ. 2017; 356: j656
- Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline.BMJ. 2017; 356: j576
- Wrong guidelines: why and how often they occur.Evid Based Med. 2017; : 1-3
- Failure of clinical practice guidelines to meet institute of medicine standards: Two more decades of little, if any, progress.Arch Intern Med. 2012; 172: 1628-1633
- Field MJ Lohr KN Clinical practice guidelines: directions for a new program. National Academies Press (US), Washington (DC)1990
- Clinical practice guidelines: Concepts, limitations and challenges.Medwave. 2020; 20: e7887
- Drug-disease and drug-drug interactions: systematic examination of recommendations in 12 UK national clinical guidelines.BMJ. 2015; 350: h949
- Comparison of the five 2011 guidelines for the treatment of carotid stenosis.J Vasc Surg. 2012; 55: 1504-1508
- Out of context: clinical practice guidelines and patients with multiple chronic conditions a systematic review.Med Care. 2014; 52: 92-100
- The validity of recommendations from clinical guidelines: A survival analysis.Cmaj. 2014; 186: 1211-1219
- Developing clinical practice guidelines: reviewing, reporting, and publishing guidelines; updating guidelines; and the emerging issues of enhancing guideline implementability and accounting for comorbid conditions in guideline development.Implement Sci. 2012; 7: 62
- Corruption of the evidence as threat and opportunity for evidence-based medicine.Harvard Health Policy Rev. 2007; 8: 145-155
- Conflict of interest policies and industry relationships of guideline development group members: a cross-sectional study of clinical practice guidelines for depression.Account Res. 2017; 24: 99-115
- Randomized controlled trials and practice guidelines: the good, the bad, and the ugly.Intensive Care Med. 2012; 38: 1911-1913
- Committee on conflict of interest in medical research, education and P. conflict of interest in medical research, education, and practice.National Academies Press, Washington, DC, US2009
- Relationships between authors of clinical practice guidelines and the pharmaceutical industry.JAMA. 2002; 287: 612
- Prevalence of financial conflicts of interest among authors of clinical guidelines related to high-revenue medications.JAMA Intern Med. 2018; 178: 1712
- Financial conflicts of interest in clinical practice guidelines: a systematic review.Mayo Clin Proc Innov Qual Outcomes. 2021; 5: 466-475
- Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and United States: cross sectional study.BMJ. 2011; 343 (d5621–d5621)
- Reporting of financial conflicts of interest by Canadian clinical practice guideline producers: a descriptive study.Can Med Assoc J. 2020; 192: E617-E625
- Conflict of interest vs. competition of interest in orthopaedic surgery.Injury. 2011; 42: 615-616
- The trustworthiness and transparency in clinical practice guidelines versus the ongoing damaging power of direct and indirect conflict of interest.Clin Dermatol. 2020; 38: 254-256
- Financial relationships between organizations that produce clinical practice guidelines and the biomedical industry: a cross-sectional study.PLOS Med. 2016; 13e1002029
Article info
Publication history
Published online: January 31, 2022
Accepted:
January 29,
2022
Editor: H.-C. PapePublication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd. All rights reserved.