Portal de Periódicos da CAPES

Introducing JAMA Clinical Guidelines Synopsis

2014; American Medical Association; Volume: 312; Issue: 12 Linguagem: Inglês

10.1001/jama.2014.12712

1538-3598

Adam S. Cifu, Andrew M. Davis, Edward H. Livingston,

Health Systems, Economic Evaluations, Quality of Life

Physicians are busy and often do not have the time to review a single topic in enough depth to successfully aggregate and synthesize current research into a single coherent theme that can guide practice, and they maynothave theexpertise to critically appraise complex primary research studies and apply the results todeterminehowbest todelivermedical care. Thepurposeof clinical guidelines is to accomplish these tasks for physicians. However, committees that prepare guidelines often fail toproduceadocument thatmostphysicians canuse. Guideline documents are often hundreds of pages long,making themdifficult and time-consuming to readanddigest. The deployment of guidelines through electronic medical record decision support tools or applications on handheld electronicdevices canbehelpful, but these tools cannotassistwith the nuanced decision making required for providing care to individual patients. Another problem with clinical guidelines is that they are not all equal. On the one hand, some guidelines are produced by committees that are unbiased butmay lack the content expertise for the clinical problem being assessed. On the other hand, someguidelinesareproducedbyhighlyspecializedcommittees thathave content expertise but aremore likely tohave conflictsof interest thatmay lead tobiasedoutcomes. Ineither situation, the resultingguidelinesdonotgeneralizewell toprimary care populations and the unique circumstances of individual patients.1 To help address these issues, in this issue of JAMA, we are launching a new series: JAMA Clinical Guidelines Synopsis.2 These brief articles concisely summarize guideline recommendations in a format designed for busy physicians. Each article will have an overview of the major recommendations from the guideline, will identify the groups that issued and funded the guideline, and will link to selected associated guidelines and resources. Each article will summarize the clinical problem, review the evidence base for the guideline, note the potential benefits or harms related to instituting the guideline’s recommendations, and suggest future areas of research. A major feature of JAMA Clinical Guidelines Synopsis articles will be a table that rates the guideline being Related article page 1248