I attended a lecture a few days ago by Karen Grimmer-Somers, a professor at the University of South Australia and Director of the Centre for Allied Health Evidence (CAHE). An adjunct professor at the University of Stellenbosch, she visits Cape Town every year or so and this year we were fortunate enough to have her visit our physiotherapy department. She gave a great talk about the emerging use of clinical guidelines in healthcare, as well as the standards around their development and discussed why we should be looking to these guidelines in our practice.
Traditionally, clinical guidelines have been viewed with suspicion by anyone interested in working from the evidence base, as “guidelines” were often little more than one individual’s personal opinion. Over the past 5 years however, the approach to producing clinical guidelines has radically changed, with vast amounts of time and resources being poured into their development.
Nowadays, a clinical guideline focuses on the current understanding of a particular condition and makes use of a diverse range of academic literature to establish an approach to best practices, based on the outcomes of a large number of the studies available. They also inform the reader what level of evidence has been used to establish “best practice”, from systematic reviews of the literature (Level A) to expert clinical opinion (Level D). This allows the clinician to make up their own mind about how solid is the foundation upon which the guideline is built and how much weight to allocate it.
Here are a few links to some of the organisations responsible for developing guidelines (in no particular order). Since different organisations are tasked with developing different guidelines, you might have to look around until you find what you’re looking for. You should also bear in mind that not only are new guidelines being developed all the time but old ones are typically reviewed every 2-3 years, so you need to make sure you have the latest version.
- NGC (National Guideline Clearinghouse)
- New Zealand Guidelines Group
- NICE (National Institute of Clinical Excellence) guidelines
- Open Clinical Practice Guidelines
- Australian Clinical Practice Guidelines publications
- SIGN (Scottish Intercollegiate Guidelines Network)
- OpenClinical (Clinical guideline applications for handheld devices)
And an article looking at both sides of the use of clinical guidelines:
With the international movement in healthcare towards evidence-based practice, it seems logical to make use of any tools available that would assist us in this regard.