Medical Guidelines


Description:

Medical Guidelines (popularly known as clinical guidelines) are a packet of documents composed of specific criteria aiding medical staff in decision making. The guidelines cover a vast portion in the medical industry such as, diagnosis, management, treatment, prognosis, prevention and other sectors. Not only do Medical Guidelines improve decision making, but they also enhance communication between the patient, and the doctor. The Institute of Medicine defines Medical Guidelines 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). In simpler terms Medical Guidelines define crucial questions relevant to medical practice, and identify decision options for greatest outcome. Since Medical Guidelines require a huge amount of information its process is divided up into two parts. The first process is having strong research evidence based on a medical question. Followed by having a solid set of recommendations based off evidence, and practical human judgement.

Problems with Medical Guidelines:
As trustworthy as Medical Guidelines are, they also have problems. Because the information provided in the guidelines is based off of EBMs there is still room for human error, and not to mention the fact that not all evidence is based on everyone in a population, but more so specific to people that experience the same occurrences.

Doctors, and physicians also find Medical Guidelines problematic, because having a document that tells you how to run your practice voids out years of studying medicine as well as personal experience. To add onto complications, Developing the guideline by medical experts in a group setting raises conflict. Most doctors, and physicians have their own opinions of how situations should be dealt with, so a lot of clashing takes place.

On Top of conflict there is also knowing medical terminology. This is a big issue in insurance, and other companies that partake in health care indirectly.

Solutions with Medical Guidelines:
Thankfully Medical Guidelines provide more solutions than problems. The guidelines are established to standardized medical care, boost quality of care, reduce risk to all consumers involved in health care, and obtain an equilibrium with medical costs.

In terms of solutions for medical professionals finding a common ground with conflicting ideas a methodologist is hired to depict the best of evidence, and place it in corresponding ranking. During general meetings one is not allowed to voice their opinion until voting is brought upon the conflict.

Not having the knowledge of certain medical terms to fully comprehend a Medical Guideline lowers readability for those unfamiliar. fortunately the guidelines provide a manual on how to read certain sections:
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Medical Guidelines & Technology:
Obama Care being implemented pushed for advances, including technology that contains algorithms specific for Medical Guideline usage. There is also computer software known as Guideline Execution Engines developed to collaborate with Electronic Medical Record (EMR) systems. The software allows for pinpointing course of actions, and treatments relevant to the issue presented.


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Critera for Medical Guidelines:
"Developed by panel of multidisciplinary experts, provide a clear explanation of the logical relationships between alternative care options and health outcomes, and provide ratings of both the quality of evidence and the strength of the recommendations." (3)

Guideline Language
Recommendation Grade
Strength of Evidence
Strong evidence supports that the practitioner should/should not do X, because...
Strong
Two or more HIGH quality studies
Moderate evidence supports that the practitioner could/could not do X, because...
Moderate
1 HIGH or 2 MODERATE quality studies
Limited evidence supports that the practitioner might/might not do X, because...
Limited
One or more LOW quality studies and/or only 1 MODERATE study
In the absence of reliable evidence, it is the opinion of the work group that…*
Consensus*
Expert opinion (no studies)*
* The work group is only permitted to make a consensus-based recommendation, when not establishing a recommendation could have catastrophic consequences (2)

How Medical Guidelines work:
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Citations:
(1) - http://www.uptodate.com/contents/clinical-practice-guidelines/abstract/1
(2) - http://www.aaos.org/research/guidelines/guide.asp
(3) - http://www.nhlbi.nih.gov/guidelines/about.htm
(4) - http://apps.who.int/medicinedocs/documents/s17078e/s17078e.pdf
(5) - http://en.wikipedia.org/wiki/Medical_guideline

(6) - http://www.birdlab.org/research-gesdor.cfm
(7) - http://www.santec.lu/icareflow