[The impact of guidelines, standards and economic restrictions on clinical decision-making processes].
Guidelines aim at improving clinical decision-making. Contrary to textbooks and reviews that want to improve medical knowledge, guidelines try to influence medical behaviour. Scientific models of clinical decision-making such as the action theory and empirical data on the effects of guidelines suggest that guidelines will not always reach their goals but can instead even lead to a deterioration in the quality of medical care. Therefore there is a need for controlled clinical trials to investigate whether guideline-exposed physicians yield better patient outcomes than guideline-naïve physicians. Guidelines should only be regarded as evidence-based if their positive effects have been empirically demonstrated.
Linden
Michael
M
Forschungsgruppe Psychosomatische Rehabilitation am Campus Benjamin Franklin der Charité und an der Rehabilitationsklinik Seehof der BfA, Teltow/Berlin. linden@zedat.fu-berlin.d
D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards; D005858:Germany; D006801:Humans; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care