Journal of evaluation in clinical practice
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Clinical practice guidelines are intended to improve patient care and outcomes. Controversy exists about the utility of guidelines and doctors' attitudes toward them. The purpose of the survey was to determine Ontario doctors' attitudes toward practice guidelines in general, awareness of, and attitudes about, Cancer Care Ontario's Practice Guideline Initiative and the evidence-based guidelines it produces, self-reported use of guidelines and, factors related to guideline use. ⋯ Ontario doctors have positive attitudes toward practice guidelines and report frequent use of them. By understanding the relationship between doctors' perceptions of specific guidelines and their subsequent adherence to them, guideline developers will be better positioned to produce quality evidence-based guidelines that doctors will find acceptable, and therefore, be more predisposed to use.
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Clinical practice guidelines (CPGs) are systematically developed statements that assist practitioners to provide appropriate evidence-based care. The purpose of this study was to evaluate the quality of currently published CPGs for stroke care and to examine the reliability and validity of the appraisal of guidelines, research and evaluation (AGREE) instrument. ⋯ There is considerable variability in quality of stroke care guidelines but stroke guidelines score higher on the AGREE rigour of development domain than CPGs from other medical fields. The Scottish Intercollegiate Guideline Network, Veterans Affairs/Department of Defence, Royal College of Physicians, and the New Zealand Guidelines Group consistently scored the highest across the domains. Stroke rehabilitation clinicians should consider these results in selecting a guideline. CPG development groups can improve their AGREE scores by considering the cost of implementing their CPGs, pilot testing their CPGs, recording conflict of interest of development panel members and providing tools supporting application of their CPGs.