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A medical guideline (also called a clinical guideline, clinical protocol or clinical practice guideline) is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. Health care is the prevention treatment and management of illness and the preservation of mental health through the services offered by the medical, Nursing Such documents have been in use for thousands of years during the entire history of medicine. All human societies have medical beliefs that provide explanations for birth, Death, and Disease. However, in contrast to previous approaches, which were often based on tradition or authority, modern medical guidelines are based on an examination of current evidence within the paradigm of evidence-based medicine. Evidence-based medicine (EBM aims to apply Evidence gained from the Scientific method to certain parts of medical practice They usually include summarized consensus statements, but unlike the latter, they also address practical issues. Medical consensus is a public statement on a particular aspect of medical knowledge available at the time it was written and that is generally agreed upon as the evidence-based

Modern clinical guidelines briefly identify, summarize and evaluate the best evidence and most current data about prevention, diagnosis, prognosis, therapy including dosage of medications, risk/benefit and cost-effectiveness. Generally speaking preventive medicine is the part of Medicine engaged with preventing Disease rather than curing it Diagnosis is the identification by Process of elimination, of the nature of anything Prognosis (older Greek πρόγνωσις modern Greek πρόγνωση - literally fore-knowing foreseeing) is a medical term denoting the Risk-benefit analysis is the comparison of the Risk of a situation to its related benefits Cost-effectiveness analysis (CEA is a form of Economic analysis that compares the relative expenditure (costs and outcomes (effects of two or more courses of action Then they define the most important questions related to clinical practice and identify all possible decision options and their outcomes. Decision making can be regarded as an outcome of mental processes ( cognitive process) leading to the selection of a course of action among several alternatives In Game theory, an outcome is a set of moves or strategies taken by the players or their Payoffs resulting from the actions or Some guidelines contain decision or computation algorithms to be followed. A medical algorithm is any Computation, Formula, Statistical survey, Nomogram, or Look-up table, useful in Healthcare. Thus, they integrate the identified decision points and respective courses of action to the clinical judgment and experience of practitioners. Many guidelines place the treatment alternatives into classes to help providers in deciding which treatment to use.

Additional objectives of clinical guidelines are to standardize medical care, to raise quality of care, to reduce several kinds of risk (to the patient, to the healthcare provider, to medical insurers and health plans) and to achieve the best balance between cost and medical parameters such as effectiveness, specificity, sensitivity, resolutiveness, etc. Standardization (or standardisation) is the process of developing and agreeing upon technical standards. The term health insurance is generally used to describe a form of Insurance that pays for medical expenses Effectiveness means the capability of producing an Effect. In Physics, an effective theory is similar to a phenomenological theory a framework intended It has been demonstrated repeatedly that the use of guidelines by healthcare providers such as hospitals is an effective way of achieving the objectives listed above, although they are not the only ones. A hospital is an institution for Health care providing treatment by specialised staff and equipment and often but not always providing for

Special computer software packages known as guideline execution engines have been developed to facilitate the use of medical guidelines in concert with an electronic medical record system. A Guideline Execution Engine is a Computer program which can interpret a clinical guideline represented in a computerized format and perform actions towards the user An electronic medical record (EMR is a Medical record in digital format The Guideline Interchange Format (GLIF) is a computer representation format for clinical guidelines that can be used with such engines. [1]

It has been found[2] that some simple clinical practice guidelines are not routinely followed to the extent they might be. It has been found that providing a nurse or other medical assistant with a checklist of recommended procedures can result in the attending physician being reminded in a timely manner regarding procedures that might have been overlooked. A nurse is responsible—along with other Health care Professionals —for the treatment safety and recovery of acutely or chronically A checklist is used as an aid to Memory. It helps to ensure consistency and completeness in carrying out a task

The guideline-based approach to healthcare is a relatively recent one and has originated in the United States in the 1990s. Guidelines are usually produced at national or international levels by medical associations or governmental bodies, such as the US Agency for Healthcare Research and Quality. Local healthcare providers may produce their own set of guidelines or adapt them from existing top-level guidelines.

The USA and other countries maintain medical guideline clearinghouses. In the USA, the National Guideline Clearinghouse maintains a catalog of high-quality guidelines published by various organizations (mostly professional physician organizations). In the United Kingdom, clinical practice guidelines are published primarily by the National Institute for Health and Clinical Excellence (NICE). In The Netherlands, two bodies (CBO and NHG) publish specialist and primary care guidelines, respectively. In Germany, the German Agency for Quality in Medicine (AEZQ) coordinates a national program for disease management guidelines. The German Agency for Quality in Medicine (AQUMED - in German "Ärztliches Zentrum für Qualität in der Medizin (ÄZQ" established in 1995 and located in Berlin All these organisations are now members of the Guidelines International Network, an international not-for-profit association of organisations and individuals involved in clinical practice guidelines. The Guidelines International Network is an international not-for-profit association of organisations and individuals involved in Clinical practice guidelines Founded in November G-I-N is owner of the International Guideline Library - the largest web based data base of medical guidelines worldwide.

See also

References

  1. ^ GLIF website
  2. ^ Gina Kolata "Program Coaxes Hospitals to See Treatments Under Their Noses". Gina Kolata (born in Baltimore Maryland, February 25, 1948) is a Science journalist for The New York Times. New York Times December 25, 2004.

External links

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