The National Guideline Clearinghouse has more than 2,000 guidelines on its website.1 The Guideline International Network (GIN) has more than 6,000 guideline-type documents on its website, and these documents are regularly reviewed and updated. The practice of medicine is now significantly influenced by guidelines. Based on the medical condition of concern, the guidelines vary in scope and complexity. With the current focus on evidence-based medicine, many guidelines now incorporate some assessment of evidence on which the recommendations are based. This is particularly helpful for practitioners, as it emphasizes the areas where recommendations are based on strong clinical evidence, compared to areas where there is significant lack of evidence.
While not the intention of guideline developers, unfortunately “guidelines” have become de facto “standards of care.” ASA clearly distinguishes between “Standards,” “Guidelines” and “Practice Advisories.”2 Each of the documents has different medico-legal and practice implications (as they are developed differently)....
