Document Detail

Review article: The role of practice guidelines and evidence-based medicine in perioperative patient safety.
MedLine Citation:
PMID:  23212699     Owner:  NLM     Status:  Publisher    
PURPOSE: The purpose of this narrative review is to discuss the impact of clinical practice guidelines on the outcomes of care and patient safety. PRINCIPAL FINDINGS: The care provided to patients has a high degree of variability, including some care that is discordant with available evidence. This inconsistency has implications for patient safety as some patients receive care that is unlikely beneficial yet may be harmful, while others are denied care that would clearly be helpful. The medical literature is expanding at an alarming rate; its quality and reliability is often poor; study methodology is frequently suboptimal, and reversal is common, even among frequently cited articles. For decades, specialty societies and other agencies have been providing clinical practice guidelines to assist physicians with the integration of evidence into clinical decision-making. Implementation of guidelines has been variable, and their goals are often not achieved due to failed uptake and application. The reasons for this shortcoming are complex and some explanations are valid. Many guidelines have not been evidence-based and many have been methodologically unsound. Physician autonomy likely also plays an important role in guideline uptake; an updated concept of autonomy that embraces appropriate guidelines is long overdue. CONCLUSIONS: Under certain conditions, guidelines can add value to care and improve outcomes; they need to be evidence-based, methodologically sound, and appropriately applied to patients and clinical scenarios. Simply summarizing evidence in a guideline is an inadequate process. To achieve the benefit of guidelines, implementation strategies need to be robust.
Edward Crosby
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-5
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthesie     Volume:  -     ISSN:  1496-8975     ISO Abbreviation:  Can J Anaesth     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Anesthesiology, University of Ottawa and The Ottawa Hospital, General Campus, Suite CCW1401, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada,
Vernacular Title:
Le rôle des directives de pratique et de la médecine fondée sur des données probantes dans la sécurité périopératoire des patients.
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