Outcomes research in the development and evaluation of practice guidelinesReport as inadecuate

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BMC Health Services Research

, 2:7

First Online: 25 March 2002Received: 01 October 2001Accepted: 25 March 2002DOI: 10.1186-1472-6963-2-7

Cite this article as: Pilote, L. & Tager, I.B. BMC Health Serv Res 2002 2: 7. doi:10.1186-1472-6963-2-7


BackgroundPractice guidelines have been developed in response to the observation that variations exist in clinical medicine that are not related to variations in the clinical presentation and severity of the disease. Despite their widespread use, however, practice guideline evaluation lacks a rigorous scientific methodology to support its development and application.

DiscussionFirstly, we review the major epidemiological foundations of practice guideline development. Secondly, we propose a chronic disease epidemiological model in which practice patterns are viewed as the exposure and outcomes of interest such as quality or cost are viewed as the disease. Sources of selection, information, confounding and temporal trend bias are identified and discussed.

SummaryThe proposed methodological framework for outcomes research to evaluate practice guidelines reflects the selection, information and confounding biases inherent in its observational nature which must be accounted for in both the design and the analysis phases of any outcomes research study.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-2-7 contains supplementary material, which is available to authorized users.

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Author: Louise Pilote - Ira B Tager

Source: https://link.springer.com/

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