Clinical guidelines: quality and implementation.

So far 60 evidence-based clinical guidelines have been developed in Finland. These are no binding rules, but they require interpretation for specific patients, and patient preferences are to be observed. For high-quality guidelines, surrogate markers must be avoided, evidence must be systematically searched for and presented, and local context has to be taken into account. The AGREE (Appraisal of Guideline Research & Evaluation) instrument for evaluation of guidelines is presented. Research on implementation and continuous evaluation of guideline effects are needed.