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The art versus the science of medicine. Are clinical practice guidelines the answer?
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Introduction |
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Clinical practice guidelines (CPGs) are systematically created recommendations to assist physicians in the decision making processes related to the choice of health interventions.1 2 There has been increasing interest in the development of CPGs within all medical fields. In 1993 there were 374 publications indexed by MEDLINE as pertaining to CPGs; by 1996, the number had increased to over 980. The American Medical Association has listed in their "Directory of Medical Parameters" over 1600 sets of guidelines.3 The enthusiasm and frenzy are such that "Guidelines for the development of guidelines" have been proposed.4 The American College of Rheumatology has also developed several sets of guidelines covering areas such as osteoarthritis, rheumatoid arthritis, and steroid induced osteoporosis.5-11
Variation in practice has been reported for most fields in medicine,
including musculoskeletal diseases, often driven by physician preferences or practice characteristics. For instance, prescriptions of
second line drugs for patients with rheumatoid arthritis vary among
rheumatologists.12 13 Demographic characteristics of
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This article has been cited by other articles:
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MAJOR, G A C
(1998). Clinical guidelines. Ann Rheum Dis
57: 444-444
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