Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY 40202, USA.
Crit Care Clin. 2010 Jul;26(3):451-66, viii. doi: 10.1016/j.ccc.2010.04.008.
The volume of clinical guidelines produced by national and international societies has virtually exploded in the literature over the past decade. The most important aspect of guidelines is transparency, that is, the connection between the recommendation or guideline statement and the underlying supportive studies from the literature should be transparent. Clinical guidelines should help organize the literature, identify key areas of patient management, and provide a framework with which the clinician may operate. The reader of a guideline should embrace controversy, trace back and review the underlying literature, and then determine whether practice should be altered as a result of the guideline recommendations. The purpose of this article is to understand the derivation of clinical guidelines, to learn how to resolve controversy or differences between guidelines and clinical practice, and to learn steps to apply the guidelines to an individual institution or clinical practice.
在过去的十年中，国家和国际社会发布的临床指南数量实际上呈爆炸式增长。指南最重要的方面是透明度，即推荐或指南陈述与文献中基础支持研究之间的联系应该是透明的。临床指南应该有助于组织文献，确定患者管理的关键领域，并提供一个框架，临床医生可以据此进行操作。指南的读者应该接受争议，追溯和审查基础文献，然后确定是否应该根据指南建议改变实践。本文的目的是了解临床指南的推导过程，学习如何解决指南与临床实践之间的争议或差异，并学习将指南应用于个别机构或临床实践的步骤。
