Failure of clinical practice guidelines to meet institute of medicine standards: Two more decades of little, if any, progress.

摘要: Background In March 2011, the Institute of Medicine (IOM) issued a new set standards for clinical practice guidelines intended to enhance quality being produced. To our knowledge, no systematic review adherence such has been undertaken since one published over decade ago. Methods Two reviewers independently screened 130 selected at random from National Guideline Clearinghouse (NGC) website compliance with 18 25 IOM standards. Results The overall median number (percentage) satisfied (out 18) was 8 (44.4%), an interquartile range 6.5 (36.1%) 9.5 (52.8%). Fewer than half surveyed met more 50% Barely third produced by subspecialty societies surveyed. Information on conflicts interest (COIs) given in fewer Of those including information, COIs were present two-thirds committee chairpersons (71.4%) and 90.5% co-chairpersons. Except US government agency–produced guidelines, criteria used select members selection process rarely described. Committees developing included information scientist or patient representative. Non-English literature, unpublished data, and/or abstracts considered guidelines; differences opinion among generally not aired benefits recommendations enumerated often potential harms. Guidelines 2006 through 2011 varied little regard average satisfied. Conclusion Analysis sample archived NGC as June demonstrated poor standards, if any improvement past 2 decades.