title: Development of clinical practice guidelines: surgical perspective.
abstract: Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. The implications of this definition are that: the methodologic perspective and operations for systematic development must be specified, a strategy is needed to account for the patient's perspective in the CPG development process and the clinical decision, and a mechanism is required to determine how appropriateness ought to be conceptualized and defined. Addressing these issues, we review models of CPG development, outline challenges to evidence-based approaches to CPG development, address unique factors relevant to the development of guidelines for the surgical community, introduce an Ontario practice guidelines strategy that uses complementary methods of CPG development, and summarize the feedback provided by the surgical community regarding the practice guidelines produced in Ontario's cancer system.
authors.affiliation: Program in Evidence-based Care, Cancer Care Ontario, c/o Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Centre, 1200 Main Street West, Room 2C9A, Hamilton, Ontario L8N.
authors.forename: M C
authors.initials: MC
authors.lastname: Brouwers
authors.forename: G P
authors.initials: GP
authors.lastname: Browman
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D013514:Surgical Procedures, Operative