Grol R
Centre for Research on Quality in Family Practice, University of Nigmegen, The Netherlands.
Br J Gen Pract. 1993 Apr;43(369):146-51.
The setting of standards for general practice care is receiving increasing attention in many countries. However, various problems have been noted in the procedures used for the development of guidelines. In this paper, a model for developing guidelines that fit into the specific general practice situation is presented. This model attempts to integrate current experiences in this area. Ideally, the development of guidelines should take place on various levels (central, local, practice and individual), each level involving different aims and methods. Thorough procedures must be used, in which attention is paid to the scientific validity of the guidelines, the reliability of the results, the clinical applicability, and in particular, the acceptance and adoption of the guidelines in practice.
在许多国家,制定全科医疗护理标准正受到越来越多的关注。然而,在制定指南所采用的程序中已发现了各种问题。本文提出了一个适用于特定全科医疗情况的指南制定模型。该模型试图整合该领域当前的经验。理想情况下,指南的制定应在多个层面(中央、地方、医疗机构和个人)进行,每个层面涉及不同的目标和方法。必须采用全面的程序,其中要关注指南的科学有效性、结果的可靠性、临床适用性,特别是指南在实际应用中的接受度和采用情况。