[Guidelines from the viewpoint of clinical economics].

In an experiment that compared the quality of medical guidelines in German cancer centers we were able to demonstrate that the selection of guidelines was not based on common criteria. These decisions were frequently based on personal preferences rather than on scientific evidence. We should consider that the scientific quality of clinical publications is easily assessed by simple methods in two dimensions, effectiveness and efficiency. This subsequently led to three conclusions: Clinical epidemiology/evidence-based medicine should be integrated into medical education. Interdisciplinary co-operation to create "common criteria for guidelines" should be supported. Politicians have the responsibility to provide the legal framework in order to ensure self administration in health care.