Drake L A, Yale K P, Lowery B J, Dunbar A L, Gillies R
Department of Dermatology, University of Oklahoma, Oklahoma City, USA.
Arch Dermatol. 1997 Nov;133(11):1369-74.
Medical practice guidelines are being developed at an accelerating pace, in all areas of medicine, for a wide range of uses. The field of practice guideline development is not new, but a number of important economic and health care issues have renewed interest in their creation. In 1987, in response to many of these issues, the American Academy of Dermatology took a leadership role and began a process designed to develop guidelines for disease entities treated by dermatologists. The result was a set of clinical practice guidelines and the most comprehensive dermatology guideline development processes to date. Herein we describe the guideline development process in its current, refined form and discuss some of its unique and important characteristics. New applications of guidelines, outside of clinical practice improvement, have made their development controversial. Nevertheless, it is important for the medical profession to lead in this effort, and the American Academy of Dermatology continues to explore ways to refine and update its guidelines to reflect the latest medical science and technology.
医学实践指南正在医学的各个领域加速制定，以用于广泛的用途。实践指南制定领域并非新生事物，但一些重要的经济和医疗保健问题重新引发了人们对其制定的兴趣。1987年，针对其中许多问题，美国皮肤病学会发挥了领导作用，启动了一个旨在为皮肤科医生治疗的疾病实体制定指南的过程。其成果是一套临床实践指南以及迄今为止最全面的皮肤病学指南制定流程。在此，我们将以当前完善后的形式描述指南制定流程，并讨论其一些独特且重要的特征。指南在临床实践改进之外的新应用使其发展引发了争议。尽管如此，医学专业在这一努力中发挥引领作用很重要，美国皮肤病学会也在继续探索完善和更新其指南的方法，以反映最新的医学科学和技术。
