michigan informatics

Appraising Practice Guidelines

Although most practice guidelines are evidence-based, there are still many which are based on partial evidence, local consensus, or simply historical practice. You will need to critically appraise each guideline that you use. From JAMA's Users Guides to Evidence-based Medicine, questions to ask include:

1. Are the results of the study valid?
   • Primary Guides:
     • Were all important options and outcomes clearly specified?
     • Was an explicit and sensible process used to identify, select, and combine evidence?
   • Secondary Guides:
     • Was an explicit and sensible process used to consider the relative value of different outcomes?
     • Is the guideline likely to account for important recent developments?
     • Has the guideline been subject to peer review and testing?
2. What were the results?
   • Are practical, clinically important, recommendations made?
   • How strong are the recommendations?
   • What is the impact of uncertainty associated with the evidence and values used in the guidelines?
3. Will the results help me in caring for my patients?
   • Is the primary objective of the guideline consistent with your objective?
   • Are the recommendations applicable to your patients [population]?