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Ethical Standards I01:25

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The American Nurses Association (ANA) created and implemented the first nationally accepted Code of Ethics for Nurses with Interpretive Statements. The Code of Ethics is a living document regularly updated by the ANA and establishes an ethical standard that is non-negotiable for nurses in all roles and settings.
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Transparency in clinical practice guidelines: the problem of consensus-based recommendations and practice points.

Cameron Venus1, Euzebiusz Jamrozik1

  • 1Department of General Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Internal Medicine Journal
|February 25, 2021
PubMed
Summary

Australian clinical practice guidelines lack clear definitions for consensus-based recommendations and practice points. This inconsistency hinders evidence-based medicine and calls for improved guideline development practices.

Keywords:
clinical practice guidelineconsensus-based recommendationevidence-based medicinemedical decision-makingpractice point

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Area of Science:

  • Health Policy
  • Medical Informatics
  • Clinical Practice Guidelines

Background:

  • Clinical practice guidelines frequently use 'consensus-based recommendations' and 'practice points' when evidence is limited.
  • These terms are intended to guide clinicians in daily practice.
  • However, their precise meaning and application can be ambiguous.

Purpose of the Study:

  • To analyze the clarity and consistency of definitions for 'consensus-based recommendations' and 'practice points' in Australian clinical practice guidelines.
  • To identify impediments to evidence-based medicine stemming from unclear guideline terminology.
  • To highlight opportunities for enhancing the development of Australian clinical guidelines.

Main Methods:

  • Systematic review of Australian clinical practice guidelines.
  • Content analysis of terminology related to recommendations and practice points.
  • Assessment of definition clarity and consistency across guidelines.

Main Results:

  • Australian clinical practice guidelines often fail to clearly define 'consensus-based recommendations' and 'practice points'.
  • Significant inconsistencies were observed in the usage of these terms across different guidelines.
  • The lack of clear definitions was identified as a barrier to effective evidence-based medicine.

Conclusions:

  • Clearer definitions and consistent application of terms like 'consensus-based recommendations' and 'practice points' are crucial for Australian clinical guidelines.
  • Reforms in guideline development are needed to improve clarity and support evidence-based practice.
  • Standardizing terminology will enhance the utility and impact of clinical practice guidelines.