ABSTRACT
Clinical practice guidelines, CPGs, are ‘systematically developed statements to assist practitioners’ and patients’ decisions about appropriate health care for specific clinical circumstances’ (Field and Lohr, 1992). Ideally CPGs should identify recommendations for appropriate and cost-effective management of clinical conditions or the appropriate use of clinical procedures with the principal aim of providing good performance (Effective Health Care, 1994). The essential prerequisite for improved quality of care is that the guideline is valid by which it is meant that adherence will increase the likelihood of obtaining the expected health outcome at the expected cost (Field and Lohr, 1992). In 1993, the Department of Health identified clinical guidelines as a means of improving clinical practice (NHS Management Executive, 1993). In 1999, the guideline industry is flourishing in the UK, with several organisations set up for the sole purpose of developing clinical practice guidelines. In general, however, the majority of clinical practice guidelines in the UK are developed by ad-hoc groups who come together for the task of developing a guideline in a particular clinical area.
