Clinical guidelines and nutrition therapy: better understanding and greater application to patient care

The volume of clinical guidelines produced by national and international societies has virtually exploded in the literature over the past decade. The most important aspect of guidelines is transparency, that is, the connection between the recommendation or guideline statement and the underlying supportive studies from the literature should be transparent. Clinical guidelines should help organize the literature, identify key areas of patient management, and provide a framework with which the clinician may operate. The reader of a guideline should embrace controversy, trace back and review the underlying literature, and then determine whether practice should be altered as a result of the guideline recommendations. The purpose of this article is to understand the derivation of clinical guidelines, to learn how to resolve controversy or differences between guidelines and clinical practice, and to learn steps to apply the guidelines to an individual institution or clinical practice.