J Am Acad Orthop Surg. 2014 Mar;22(3):135-44. doi: 10.5435/JAAOS-22-03-135.
Evidence-based clinical practice guidelines (CPGs) have the potential to bring the best-quality evidence to orthopaedic surgeons and their patients. CPGs can improve quality by decreasing the variability in orthopaedic care, but they can also be misused through inappropriate development or application. The quality of a CPG is dependent on the strength of its evidence base, which is often deficient in orthopaedic publications. In addition, many surgeons express concern about legal liability associated with CPGs. Specific processes in CPG development and implementation can counter these potential problems. Other evidence tools, such as appropriate use criteria, also can help in the application of the proper treatment of patients by identifying those who are appropriate for specific procedures. Because payers, patients, and surgeons need access to the best evidence, CPGs will continue to be developed, and orthopaedic surgeons have the opportunity to ensure their proper development and implementation by understanding and participating in the process.
循证临床实践指南（CPGs）有可能为骨科医生及其患者带来最佳质量的证据。CPGs 可以通过减少骨科护理中的变异性来提高质量，但也可能因不当开发或应用而被滥用。CPG 的质量取决于其证据基础的强度，而这在骨科出版物中往往是不足的。此外，许多外科医生对与 CPG 相关的法律责任表示关注。CPG 开发和实施中的特定流程可以解决这些潜在问题。其他证据工具，如适当的使用标准，也可以通过确定哪些患者适合特定程序来帮助对患者进行适当的治疗。由于支付者、患者和外科医生需要获得最佳证据，CPGs 将继续得到开发，而骨科外科医生有机会通过了解和参与该过程来确保其正确的开发和实施。
