Good medical practice, evidence-based medicine (EBM) and clinical practice guidelines (CPG) have been recurring subjects in the scientific literature. EBM advocates argue that good medical practice should be guided by evidence-based CPG. On the other hand, critical authors of EBM methodology argue that various interests undermine the quality of evidence and reliability of CPG recommendations. The purpose of this paper is to evaluate patient related outcomes of CPG implementation, in light of EBM critics.
The authors opted for a rapid literature review.
There are few studies evaluating the effectiveness of CPG in patient-related outcomes. The systematic reviews found are not conclusive, although they suggest a positive impact of CPGs in relevant outcomes.
This work was not a systematic review of literature, which is its main limitation. On the other hand, arguments from EBM and CPG critics were considered, and thus it can enlighten health institutions to recognize the caveats and to establish policies toward care improvement.
The paper is the first of its kind to discuss, based on the published literature, next steps toward better health practice, while acknowledging the caveats of this process.
The authors kindly express gratitude to all the participants of the Oxford CEBM e-mail list that provided insight and references during the discussion that started the present work.
de Vasconcelos, L.P., de Oliveira Rodrigues, L. and Nobre, M.R.C. (2019), "Clinical guidelines and patient related outcomes: summary of evidence and recommendations", International Journal of Health Governance, Vol. 24 No. 3, pp. 230-238. https://doi.org/10.1108/IJHG-12-2018-0073Download as .RIS
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