When treating patients, doctors and other healthcare providers often are faced with difficult decisions and considerable uncertainty. They rely on the scientific literature, in addition to their knowledge, experience, and patient preferences, to inform their decisions. Clinical practice guidelines are statements that include recommendations intended to optimize patient care. They are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.
Because of the large number of clinical practice guidelines available, practitioners and other guideline users find it challenging to determine which guidelines are of high quality. If guideline users had a mechanism to immediately identify high quality, trustworthy clinical practice guidelines, their health-related decision making would be improved—potentially improving both health care quality and health outcomes.
The U.S. Congress, through the Medicare Improvements for Patients and Providers Act of 2008, asked the IOM to undertake a study on the best methods used in developing clinical practice guidelines. The IOM developed eight standards for developing rigorous, trustworthy clinical practice guidelines (see the complete list of standards). To properly evaluate the effects of the standards on clinical practice guidelines development and health care quality and outcomes, the IOM encourages the Agency for Health Care Research and Quality to pilot-test the standards and assess their reliability and validity. While there always will be uncertainty in clinical practice, ensuring that clinicians have trustworthy guidelines will bring more evidence to bear on clinician and patient decision making.