[Clinical practice guidelines in Japan: toward their appropriate use and diffusion].
In Japan, the governmental report on health technology assessment in 1999 referred to the need to develop evidence-based clinical practice guidelines. The Ministry of Health and Welfare established priorities for the development of clinical practice guidelines, and started several projects. About 20 clinical practice guidelines are to be developed by 2004. However, what "guideline" means and how "guidelines" work are unclear because the word "guideline" is ambiguous in Japan. Although it is generally accepted that "directives are stronger than recommendations, which are stronger than guidelines" in the western countries, Japanese people do not usually recognize these distinctions and tend to regard guidelines as mandatory directives even in individual cases. Patients, consumers and legal professionals may overestimate the authority of clinical practice guidelines when they see them. What clinical practice guidelines are, or are not should be clarified appropriately. Autumn 2003, the Japan Council for Quality Health Care will open the information service that provides practice guidelines and related literature. This will be accessible to both healthcare professionals and the general public. Much remains to be done to bring other stakeholders to the table. All of Japanese society can, and needs to, participate in the process of developing a consensus on clinical practice guidelines.
Nakayama
Takeo
T
Department of Health Informatics, Kyoto University School of Public Health.
D003256:Community Participation; D016265:Conflict of Interest; D032921:Consensus; D019317:Evidence-Based Medicine; D006077:Government Agencies; D006801:Humans; D033181:Information Dissemination; D007256:Information Systems; D020407:Internet; D007564:Japan; D017410:Practice Guidelines as Topic