Hölzel D, Engel J, Schmidt M
Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München.
Z Arztl Fortbild Qualitatssich. 1999 Jan;93(1):15-22.
Several activities regarding guidelines have been developed in Germany within a short time. It is desirable especially in the field of oncology that procedures are stated as proven effective, proven ineffective, and possibly effective by using procedures of evidence based medicine. However, the low impact of guidelines on the medical practice has to be taken into account. The kind of errors of known deviations should decrease the expectations. This altogether should motivate for a closer look what really happens in the daily routine. It should also reflect the hospital's and physician's outcome and might provide hints to medical standards. Improving the still insufficient documentation, which may describe quality of care, can provide important features. This has to be remembered when undertaking activities regarding guidelines.
在德国，短时间内就开展了几项与指南相关的活动。尤其是在肿瘤学领域，希望通过循证医学的方法将程序明确表述为已证实有效、已证实无效以及可能有效。然而，必须考虑到指南对医疗实践的影响较小。已知偏差的错误类型应降低预期。总体而言，这应促使人们更仔细地审视日常实际发生的情况。它还应反映医院和医生的治疗结果，并可能为医疗标准提供线索。改善目前仍不充分的、可能描述护理质量的文档记录，可提供重要信息。在开展与指南相关的活动时必须牢记这一点。
