[Previous experiences with the evaluation of guidelines. Disillusionment after an enthusiastic start]

The evaluation of medical guidelines shows that the development and implementation of medical guidelines have failed to meet the high expectations raised both in Germany and internationally. Especially, the quality of German guidelines has been strongly criticized. Since then, several 'guidelines for guidelines' were published, and a variety of other measures were taken to define quality standards for the development and implementation of guidelines. It is expected that the application of these new standards will improve the quality of medical guidelines and therefore increase the chances for a more successful implementation. Only guidelines with high quality and wide acceptance, which are actually applied, will have positive effects on the process and outcome of medical care. But guidelines are only one way to improve the quality of medical care. The decision about the development and use of new guidelines should be based on the careful consideration of possible improvements and disadvantages.