Ethnic specific recommendations in clinical practice guidelines: a first exploratory comparison between guidelines from the USA, Canada, the UK, and the Netherlands.
OBJECTIVE
To investigate whether clinical practice guidelines in different countries take ethnic differences between patients into consideration and to assess the scientific foundation of such ethnic specific recommendations.


METHODS
Analysis of the primary care sections of clinical practice guidelines.


METHODS
Primary care practice guidelines for type 2 diabetes mellitus, hypertension, and asthma developed in the USA, Canada, the UK, and the Netherlands.


METHODS
Enumeration of the ethnic specific information and recommendations in the guidelines, and the scientific basis and strength of this evidence.


RESULTS
Different guidelines do address ethnic differences between patients, but to a varying extent. The USA guidelines contained the most ethnic specific statements and the Dutch guidelines the least. Most ethnic specific statements were backed by scientific evidence, usually arising from descriptive studies or narrative reviews.


CONCLUSIONS
The attention given to ethnic differences between patients in clinical guidelines varies between countries. Guideline developers should be aware of the potential problems of ignoring differences in ethnicity.
Manna
D R
DR
Department of Health Policy & Management, Erasmus MC, Rotterdam, The Netherlands. Manna@bmg.eur.nl
Bruijnzeels
M A
MA
Mokkink
H G A
HG
Berg
M
M
D001249:Asthma / Q000208:ethnology / Q000628:therapy; D002170:Canada; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy; D005006:Ethnicity; D019317:Evidence-Based Medicine; D006302:Health Services Research; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000628:therapy; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D006113:United Kingdom; D014481:United States