Nieweg O E
Het Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis, afd. Heelkunde, Plesmanlaan 121, 1066 CX Amsterdam.
Ned Tijdschr Geneeskd. 2007 Jun 9;151(23):1272-5.
National and international guidelines for diagnosis and treatment are increasingly applied as standards for medical interventions. Evidence-based consensus guidelines are not consistently based on the outcome of scientific studies. Recent research yielding inherent low-grade evidence is liable to be overruled by personal impressions, sentiments and common sense. Guidelines are based on the average patient, with a certain range. With increasing specialisation, one increasingly sees that doctors justifiably digress from a guideline when a patient differs substantially from the average.
国家和国际诊断与治疗指南越来越多地被用作医疗干预的标准。基于证据的共识性指南并非始终基于科学研究的结果。近期产生内在低级别证据的研究容易被个人印象、情感和常识所否决。指南是基于一定范围内的普通患者制定的。随着专业化程度的提高，人们越来越多地看到，当患者与普通患者有很大差异时，医生有理由偏离指南。
