Your critical stance in reviewing guidelines should include their level of quality as well as their appropriateness to your patient and the problem. The rigor and strength of the research evidence and the guideline development process may vary. The following sources offer question lists for you to use in your assessment.
AGREE is an "international collaboration of researchers and policy makers who work together to improve the quality and effectiveness of clinical practice guidelines by establishing a shared framework for their development, reporting and assessment." With funding from the European Union and coordination by St. George's Hospital Medical School, the group developed an appraisal instrument to assess existing guidelines and add uniformity to guideline development. Instructions for instrument use are included.
Evidence-based Medicine Working Group. "Users' guides to the medical literature. VIII. How to use clinical practice guidelines. A. Are the recommendations valid?" JAMA 274, 7 (August 16, 1995): 570-4.
Evidence-based Medicine Working Group. "Users' guides to the medical literature. VIII. How to use clinical practice guidelines. B. What are the recommendations and will they help you in caring for your patients?" JAMA 274, 20 (November 22/29, 1995): 1630-2.
How to Use a Clinical Practice Guideline (Evidence-based Medicine Working Group)
A web based synthesis of the above two articles.
What Makes a Good Clinical Guideline? (PDF file)
Includes evaluation checklist with questions arranged in 15 categories. Adapted from St. George's Health Care Evaluation Unit's Appraisal Instrument for Clinical Guidelines, the Leicestershire Evidence Based Guidelines Checklist and the U. S. Agency for Health Care Research and Quality Guidelines.
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