[Evidence-based guidelines in the organization of medical care]

Organizational as well as managerial aspects can influence the outcome of patient care, in the establishment of a stroke service unit for instance. Critics wonder whether organisational aspects should be excluded from evidence-based guidelines as strong evidence is often lacking and managers are not included in the working party. It can be argued that it is neither the outcome nor the strength of the published evidence that determines whether a guideline is evidence-based but the method of guideline development. This includes a systematic search and critical appraisal of the literature as well as a rigorous external review in order to achieve consensus on statements including those pertaining to organization of care, for which evidence is poor or lacking.