title: [Issues of practice guideline].
abstract: "Practice Guideline (PG) or management guideline" is not an impeccable guideline but a tool to support a clinical decision, i.e., one of factors to make a clinical decision. When making a clinical decision, medical practice is finalized, taking into consideration of PG, patient's preference, social and national healthcare system. Even if PG provides a treatment method on the basis of high level evidences, we should not always uniformly apply to every patient. We can practice better with combination of PG, physician's expertise, patients' preference. When consulting PG, it is recommended to confirm in advance what society/organization prepared PG, purpose of preparation, preparation process, and developmental method, including social fairness whether healthcare cost is assumed in PG or whether industry is a substantial editor. As to the questions whose answer is not mentioned in PG, their controversial points have to be defined and assessed, retrieving literatures. This is so called implementation of "Evidence-Based Medicine (EBM)." The practice of EMB provides better evidences. PG is fated to be always outdated when published because new evidence will be additionally published, and therefore, it is always required to search for new evidences available at daily practice.
authors.affiliation: Department of Neurology, Kagawa Prefectural Central Hospital.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Yamamoto
mesh_terms: D000978:Antiparkinson Agents / Q000191:economics / Q000627:therapeutic use; D003657:Decision Making; D016527:Drug Costs; D019317:Evidence-Based Medicine; D006801:Humans; D010300:Parkinson Disease / Q000188:drug therapy; D010358:Patient Participation; D017410:Practice Guidelines as Topic
chemical_list: D000978:Antiparkinson Agents