Development and use of clinical practice guidelines on venous thromboembolism

Venous thromboembolism (VTE) is a common disorder associated with substantial morbidity and mortality. It may be encountered by clinicians in virtually all medical specialties and healthcare settings. A large number of clinical practice guidelines (CPGs) on VTE have been published in recent years to support clinicians in delivering high-quality care for the prevention, diagnosis, and management of VTE. Essential elements of CPGs include a guideline panel composed of content experts from multiple disciplines, methodologists, and representatives from key affected groups; a systematic review of evidence; consideration of patient subgroups and patient values and preferences; management of conflicts of interest; an explanation of the relationship between alternative care options and health outcomes; and rating of the quality of evidence and strength of recommendations. These elements enhance the transparency and trustworthiness of CPGs and set them apart from other types of clinical guidance documents. The objectives of this narrative review are to summarize methods used to develop CPGs and to provide guidance to end-users on how to interpret recommendations and apply them in clinical practice. While much of the content of this review applies to CPGs in general, irrespective of disease focus, a number of examples specific to VTE are included.