CPGs: to reach the unreachable goal?
Online posting: July 25, 1997
Published in print: December 1, 1997 (CMAJ 1997;157:1510)
Re: The effects of clinical practice guidelines on patient
outcomes in primary care: a systematic review, by Graham Worrall,
Paul Chaulk and Darren Freake, CMAJ
1997;156:1705-12
Canadian physicians' attitudes about and preferences regarding
clinical practice guidelines, by Robert S.A. Hayward, Gordon H.
Guyatt, Karen-Ann Moore, Ann McKibbon and Anne O. Carter, Can
Med Assoc J 1997;156:1715-23 [full text / résumé]
Clinical practice guidelines on trial, by Robert S.A. Hayward
CMAJ 1997;156:1725-7 [full text / résumé]
These articles and editorial on clinical practice guidelines are
valuable additions to the literature on this topic. As Dr.
Hayward describes, we must strive to obtain the proof that
guidelines produce significantly improved outcomes.
However, I am concerned with the concept that change in
patient outcomes is the only measure of success or failure of
guidelines. In my view, a guideline that can reduce the resources
needed to care for a patient, without changing the patient
outcome, releases resources to be used elsewhere and can hardly
be seen as a failure. We should set high standards, but let us
not make them unattainable or unrealistic.
Howard Platt, MB, ChB
BC Ministry of Health and Ministry Responsible for Seniors
Victoria, BC
HPLATT@BCSD02.GOV.BC.CA
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