Clarity Guidelines use precise definitions, unambiguous language, and user-friendly formats. Schedules Guidelines state when and how they are to review be reviewed. Utilisation Guidelines indicate ways in which adherence review to recommendations can be sensibly monitored. Local development Despite its confirmation in a number of studies the Bulletin questions the received view that local development is an important positive factor in the acceptance of guidelines by clinicians. Local development of clinical practice guidelines is potentially contradictory.
Guidelines seek to reduce medical practice variation.
The existence of a variety of guidelines for the same condition, developed locally, nationally and internationally, can complicate and undermine the process of introducing guidelines. Even though guidelines are aimed at improving outcomes they place heavy emphasis on process. The evidence that guidelines improve outcomes is equivocal, using the results of the best UK-based evaluation. The bulletin believes they are. Unfortunately, there are no studies of the use of guidelines by purchasers to review and doubts must remain about their efficacy when used this way.