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Proposed New Definitions of Practice Guidelines for Health and Health Care
Toshio Morizane1, Fujimi Kawai1, Noriko Kojimahara1
1Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan.
Abstract:
Clinical practice guidelines (CPGs) are traditionally defined as systematically developed recommendations designed to optimize patient care, primarily within clinical settings under physician supervision. However, the scope of health-related decision-making has expanded considerably, now encompassing interventions implemented by various health professionals and even the general public. This evolving landscape necessitates a broader and more nuanced classification of health-related guidelines. In this opinion paper, we propose a revised framework that categorizes guidelines into three distinct types: CPGs, health care guidelines (HcGs), and health guidelines (HGs). CPGs remain focused on physician-led care but may include health-related practices outside clinical settings when relevant to patient outcomes. HcGs address evidence-based practices conducted by licensed non-physician professionals such as nurses, pharmacists, and physical therapists. HGs pertain to practices adopted by the general public-such as diet, exercise, and wellness behaviors-that do not require professional supervision. We also differentiate between "guidelines," which provide comprehensive recommendations across a broad range of topics, and "guidance," which offers targeted recommendations on specific issues. Additionally, we discuss "consensus statements" as a valid alternative when systematic reviews are not feasible. By clarifying terminology and aligning guideline types with their intended audiences and settings, this framework aims to reduce confusion, improve usability, and promote evidence-based practices across the health care and public spectrum. Adoption of this classification supports a whole-of-society approach to health, aligning with the World Health Organization's vision for integrated and equitable primary health care systems.
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