Clincal guidlines

Question 1

What is EBM?

Answer 1

Evidence-based medicine is all about the clinical decision making.
- The best available research evidence
- Patient preferences, values, and characteristics.
- Practitioners’ knowledge and expertise.
- Environmental and organisational context.

Question 2

What is a clinical guidline

Answer 2

• CPG- related to clinical matters. Generally dealing with clinical conditions or symptoms that are typically intended for use by health care providers and clinical managers. They can include best practice statements for any one or combination of concerns regarding screening, diagnosis, management, or monitoring.
• Systematically developed statements to assist practitioners and patients in making decisions about appropriate health care specific to the clinical circumstance.
• They suggest how clinicians should diagnose and manage patients.
• They are not fixed protocols that must be followed but are intended for clinicians to consider. They are not a substitute for a knowledgeable and experienced clinical’s advice.

Question 3

What is shared desicion making ?

Answer 3

• Shared decision making is a joint pricess in which a healthcare professional works together with a person to decide on care.
• It involves choosing tests and treatments based both on evidence, and on the persons individual preferences, beliefs, and values.
• It makes sure the person understands the risks, benefits, and possible consequences of the different options through discussion and information sharing

Question 4

Who drives the production of clinical guidlines ?

Answer 4

• Professional bodies, eg NICE, BMJ, NHS, BTS. Although these don’t always agree with one another.
• Today, a systematic multidisciplinary approach to preparing evidence-based guidelines is implemented,
• The NHS uses a critical appraisal instrument to determine which guideline to apply to health authorities.
• National guidelines are converted at the local level into formats that encourage adoption in practice.

Question 5

What do NICE offer guidlines for ?

Answer 5

• Clinical care
• Social care
• Public health matters
• Medicine practice
• Cancer services
• Antimicrobial prescribing.

Question 6

What makes a good guidline ?

Answer 6

• Valid
• Reproducible
• Cost-effective
• Clonally applicable
• Clear
• Flexible
• Reviewable
• Can be used in clinical audit.

Question 7

What do clinical guidlines contain ?

Answer 7

• Key priorities for implementation
• An algorithm of the care pathway
• A list of all tge recommendations
• A list of all the research recommendations
• If the guideline is up to date
• A list of the other versions of the guidelines

Question 8

How to develope a guidline ?

Answer 8

1- Decide what you want the guideline to be about.
2- Gather your team of specialist in: literature searching and retrival, epidemiology, biostatistics, health services research, clinical experts, group process experts, writers and editors.
3- Identify the evidence to use with a systematic review to collect all available evidence, assess how useful it is to the clinical questions, inspects for bias.
4- Summarise the evidence, benefits, harm, the cost of interventions.