Clinical Practice Guidelines What’s Next?

Clinical practice guidelines are a key component of medicine, as they provide evidence-based recommendations for physicians and other health care professionals about the management of care for patients with diseases or other clinical conditions. A number of important developments involving clinical practice guidelines have emerged in the past few years. This Viewpoint discusses some of the more important of these.

The release of the 2011 Institute of Medicine (IOM, now the National Academy of Medicine) report Clinical Practice Guidelines We Can Trust was an important step forward.¹ With this report, for the first time, an authoritative body proposed methods for guideline development that could no longer be ignored. According to the IOM report, clinical practice guidelines are defined as “statements that include recommendations, intended to optimize patient care, that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.”¹ Since 2011, a set of practice recommendations not explicitly informed by a systematic review should no longer be considered a clinical practice guideline. This change in definition resulted in a reduction of nearly 50% in the number of guidelines listed on the National Guideline Clearinghouse (NGC), from 2619 in 2014 to 1440 in 2018 (as older guidelines without a systematic review are removed from the site).