Clinical practice guidelines are formed and implemented in clinical situations and specify criteria with respect to diagnoses and treatment in healthcare, as well as regarding clinical management (Davis & Taylor-Vaisey., 1997)…
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Modern clinical practice guidelines are often evaluated using the GLIA system (GuideLine Implementability Appraisal) and the AGREE instrument (Appraisal of Guidelines for Research and Evaluation). The availability of these systems is evidence of how carefully regulated these guidelines are and how they can be particularly useful in clinical situations (Field et al., 1990). The principal steps in developing a clinical practice guideline are as follows. In the first instance, the correct information needs to be identified and this should be the most current and most relevant data available concerning the diagnosis, treatment and management of the illness in question. Information should also be gathered about the cost and risk of the above, where applicable (Davis & Taylor-Vaisey, 1997). Having put all this data in place, it is then necessary to condense the information to provide it in a format readily available to clinicians (Michie & Johnston, 2004) and condense this into a format useable in practical situations. Then, clinicians must implement the guidelines (Davis & Taylor-Vaisey, 1997), although this has been found to be difficult in many cases (Cabana et al., 1999; Michie & Lester, 2005). Clinical practice guidelines can involve computer algorithms, and their formulation can be heavily reliant on information technology (Field et al., 1990). The purpose of the AGREE instrument is to stress that the usefulness of these clinical practice guidelines is proportional to the quality of the guidelines themselves. This means that the AGREE instrument is primarily concerned with providing a framework with which to assess these guidelines, and states that it will: Assess the quality of guidelines; Provide a methodological strategy for the development of guidelines; and Inform what information and how information ought to be reported in guidelines. (AGREE Next Steps Consortium, 2009) This is taken from the newest version of the AGREE instrument, which is currently version two. As is evidenced by these statements, the AGREE instrument aims to ensure that all guidelines will beneficial to both clinicians and patients. Clinical practice guidelines should provide the very best and most recent research to clinicians so that treatment, diagnosis and management of the illness in question is of the best standard possible. The AGREE instrument also ensures that clinical practice guidelines are formulated in a methodical way, and so all clinical practice guidelines formulated using this tool will be of the same standard and format, and thus the AGREE instrument is now a reliable quality evaluation tool. The AGREE instrument separates the information it provides into domains. The first domain is known as ‘scope and purpose’, which basically ensures that the basic properties of the guideline are adequately described, such as the target audience, the health questions and the objectives. The second domain is ‘stakeholder involvement’ which suggests that the discussion of the guideline involves professionals from every available and appropriate area, and that the target audience have also been consulted also. The third domain is defined as ‘rigour of development’ and essentially aims to ensure that all the evidence has been selected in an appropriate manner and that this is described in the guideline, that the strengths and weaknesses of the evidence are recognized, and that the guideline explicitly references this evidence. It also aims to provide information on how to update the procedure when necessary. The fourth domain is ‘clarity of presentation’ and aims to ensure th
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