RAND Corporation, Santa Monica, CA 90407, USA.
Implement Sci. 2012 Jul 4;7:62. doi: 10.1186/1748-5908-7-62.
Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this third paper we discuss the issues of: reviewing, reporting, and publishing guidelines; updating guidelines; and the two emerging issues of enhancing guideline implementability and how guideline developers should approach dealing with the issue of patients who will be the subject of guidelines having co-morbid conditions.
临床实践指南是改善医疗保健的基础之一。1999 年,我们撰写了一篇关于制定指南方法的论文。自发表以来,指南制定方法在方法和必要程序方面都有所发展,指南制定的背景也随着指南清理机构和大规模指南制作组织(如英国国家卫生与临床优化研究所)的出现而发生了变化。因此,在三篇文章中更新和扩展我们早期的论文似乎是及时的。在本文的第三部分,我们讨论了以下问题:指南的审查、报告和发布;指南的更新;以及两个新出现的问题,即增强指南的可执行性,以及指南制定者应如何处理将成为指南对象的患者合并病症的问题。
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