Going Dutch? How to make clinical guidelines work: an innovative report from Holland

This article describes the findings of a recent Dutch enquiry on the translation of modern medical evidence and research into good clinical practice. There is a huge current increase in 'clinical guidelines' for many diseases, but even when reasonably evidence-based, there is little evidence that they positively affect clinical practice and patient care to any great extent. Educational and management issues are as important as the quality of the clinical advice. Patient acceptance factors also need to be considered.